A Review of Venous Thromboembolism Phenomena in COVID-19 Patients

Adams²,

2021

Eur Radiol

Purpose To investigate, in a meta-analysis, the frequency of pulmonary embolism (PE) in patients with COVID-19 and whether D-dimer assessment may be useful to select patients for computed tomography pulmonary angiography (CTPA). Methods A systematic literature search was performed for original studies which reported the frequency of PE on CTPA in patients with COVID-19. The frequency of PE, the location of PE, and the standardized mean difference (SMD) of D-dimer levels between patients with and without PE were pooled by random effects models. Results Seventy-one studies were included. Pooled frequencies of PE in patients with COVID-19 at the emergency department (ED), general wards, and intensive care unit (ICU) were 17.9% (95% CI: 12.0–23.8%), 23.9% (95% CI: 15.2–32.7%), and 48.6% (95% CI: 41.0–56.1%), respectively. PE was more commonly located in peripheral than in main pulmonary arteries (pooled frequency of 65.3% [95% CI: 60.0–70.1%] vs. 32.9% [95% CI: 26.7–39.0%]; OR = 3.540 [95% CI: 2.308–5.431%]). Patients with PE had significantly higher D-dimer levels (pooled SMD of 1.096 [95% CI, 0.844–1.349]). D-dimer cutoff levels which have been used to identify patients with PE varied between 1000 and 4800 μg/L. Conclusion The frequency of PE in patients with COVID-19 is highest in the ICU, followed by general wards and the ED. PE in COVID-19 is more commonly located in peripheral than in central pulmonary arteries, which suggests local thrombosis to play a major role. D-dimer assessment may help to select patients with COVID-19 for CTPA, using D-dimer cutoff levels of at least 1000 μg/L. Key Points • The frequency of PE in patients with COVID-19 is highest in the ICU, followed by general wards and the ED. • PE in COVID-19 is more commonly located in peripheral than in central pulmonary arteries. • D-dimer levels are significantly higher in patients with COVID-19 who have PE. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08003-8.

Section: Introductionmentioning

confidence: 99%

Pulmonary embolism in patients with COVID-19 and value of D-dimer assessment: a meta-analysis

Adams²,

2021

Eur Radiol

Journal of Infection and Chemotherapy

“…Coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China, in December 2019 and subsequently spread globally [1]. Many articles have reported that it causes coagulation abnormalities and pulmonary thrombosis, contributing to poorer prognosis [2,3]. The prognosis of COVID-19 is improved by the use of anticoagulant agents during hospitalization [4].…”

Section: Introductionmentioning

confidence: 99%

The influence of pre-admission antiplatelet and anticoagulation therapy on the illness severity in hospitalized patients with COVID-19 in Japan

Togano

Uemura

Asai

et al. 2021

Introduction Many articles have reported that the coronavirus disease 2019 (COVID-19) causes coagulation abnormalities and pulmonary thrombosis, contributing to a poorer prognosis. The study aimed to evaluate whether pre-admission anticoagulation and antiplatelet therapy prevented severe COVID-19 illness or not. Materials and Methods We conducted a study to determine whether taking antiplatelet or anticoagulation agents before admission affected the severity on admission using a large nationwide cohort of hospitalized COVID-19 patients in Japan. We analyzed a large nationwide cohort of hospitalized COVID-19 patients in Japan from February 9 to July 31, 2020. Results and Conclusion A total of 4265 patients from 342 facilities in Japan were included. Their use was associated with a slight reduction in the disease severity on admission in a propensity score-matched analysis which controlled for underlying diseases. However, this difference was not statistically significant.

“…In this analysis, we also found several common symptoms (mild, severe, and long-term complications) of COVID-19 are enriched at a cut off value 4. These include influenza (Rank-5) [129], dengue (Rank-7) [130], fever / severe fever with thrombocytopenia syndrome (Rank-12) [5], pain (Rank-13) [18], dermatomyositis (Rank-14) [131], embolism / thrombosis (Rank-15) [132], dyspnea / dependence on respirator (ventilator) (Rank-16) [5], conjunctivitis (Rank-17) [99], pneumonia / pneumonitis (Rank-17) [86], lchthyosis / keratosis (Rank-17) [133], throat pain / strep throat / cold sores (Rank-18) [134], fatigue/ transient alteration of awareness (Rank-18) [5], abnormal chest sounds and nonspecific chest pain (Rank-18) [134], anxiety disorder (Rank-18) [135], infectious myocarditis (Rank-18) [136, 137], aneurysm (Rank-18) [138], and myositis (Rank-18) [139], ( Fig-4 ). However, we could not find any report of COVID-19 association with cervical radiculitis (Rank-17), adjustment reaction (Rank-17), and dysmenorrhea pain (Rank-18).…”

Section: Resultsmentioning

confidence: 99%

A novel multi-omics-based identification of symptoms, comorbid conditions, and possible long-term complications in COVID-19

Barh

Tiwari

Andrade

et al. 2020

Preprint

Till date the comprehensive clinical pictures, comorbid conditions, and long-term complications of COVID-19 are not known. Recently using a multi-omics-based strategy, we have predicted the drugs for COVID-19 management with ∼70% accuracy. Here, using a similar multi-omics-based bioinformatics approach and three-ways of analysis, we identified the symptoms, comorbid conditions, and short, mid and possible long-term complications of COVID-19 with ∼90% precision. In our analysis (i) we identified 27 parent, 170 child, and 403 specific conditions associated with COVID-19. (ii) Among the specific conditions, 36 are viral and 53 short-term, 62 short to mid to long-term, 194 mid to long-term, and 57 are congenital conditions. (iii) At a cut off “count of occurrence” of 4, we found ∼ 90% of the enriched conditions are associated with COVID-19. (iv) Except the dry cough and loss of taste, all other COVID-19 associated mild and severe symptoms are enriched. (v) Cardiovascular, pulmonary, metabolic, musculoskeletal, neuropsychiatric, kidney, liver, and immune system disorders are found as top comorbid conditions. (vi) Specific diseases such as myocardial infarction, hypertension, COPD, lung injury, diabetes, cirrhosis, mood disorders, dementia, macular degeneration, chronic kidney disease, lupus, arthritis etc. along with several other diseases are also enriched as top candidates. (vii) Interestingly, many cancers and congenital disorders associated with COVID-19 severity are also identified. (viii) Arthritis, dermatomyositis, glioma, diabetes, psychiatric disorder, cardiovascular diseases having bidirectional relationship with COVID-19 are also found as top ranked conditions. Based on the accuracy (∼90%) of this analysis, long presence of SARS-CoV-2 RNA in human, and our previously proposed “genetic remittance” assumption, we hypothesize that all the identified comorbid conditions including the short-long-mid and mid-long non-communicable diseases (NCDs) could also be long-term consequences in COVID-19 survivors and warrants long-term observational studies.