Humanitas COVID-19 Task Force Venous and Arterial Thromboembolic Complications in COVID-19 Patients Admitted to an Academic Hospital in Milan, Italy

Abstract

ence to, the wearing of elastic compression stockings by patients with chronic venous insufficiency (CVI), including knowledge and awareness of the need and their efficacy and patient discomfort.Study Summary: This qualitative study assessed 10 patients with CVI who were undergoing elective surgical intervention. Focused semistructured face-to-face interviews were performed by experienced qualitative researchers with patients chosen because of their noncompliance with graduated compression stockings (CS). The patients were from a variety of socioeconomic backgrounds and a mix of urban and rural. Four major themes emerged: knowledge gap about CVI and utility of CS, lack of healthcare provider advice, discomfort, and sociopsychological factors, including cost.Commentary: CS can be uncomfortable, irritating, and hot. However, better education and motivation might help patients with CVI understand their important role as a treatment of their varicosities, edema, ulcerations, and recurrence. This will require time and effort from healthcare providers. In addition, insurance companies should cover the cost of CS.

Coronavirus Disease 2019 (COVID-19): A Haematologist’s Perspective

“…Symptomatic VTE was detected in 21 out of 75 (28%) ICU patients and 4 out of 123 (3.3%) ward patients (sub-distribution hazard ratios 3.9; 95% CI 1.3-12) [99]. Lodigiani et al [100] studied venous and arterial thromboembolic complications in 388 hospitalized patients. Thromboprophylaxis was used in all ICU patients and 75% of those on the general ward.…”

Course of D-Dimer and C-Reactive Protein Levels in Survivors and Nonsurvivors with COVID-19 Pneumonia: A Retrospective Analysis of 577 Patients

“…Patients were admitted to a university hospital (Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy) from February to April 2020. 7 For this analysis, we focused only on the temporal course of D-dimer and CRP, as these biomarkers were most frequently used for patient monitoring after early descriptions of their potential prognostic value in COVID-19. 4 We refrained from analysis of venous thromboembolic (VTE) events, because this topic has been extensively addressed 7,8 and because D-dimer levels often guided VTE imaging, which might have led to erroneous risk estimates.…”

Pragmatic Recommendations for the Management of Anticoagulation and Venous Thrombotic Disease for Hospitalized Patients with COVID-19 in Low- and Middle-Income Countries

“…2 Patients hospitalized for COVID-19, especially those requiring intensive care, are increasingly recognized to be at higher risk for VTE. 3 The WHO, 4 the American NIH, 5 and International Society on Thrombosis and Haemostasis, 6 among other societies, 7,8 recognize that all hospitalized COVID-19 patients are at high risk for VTE. Therefore, the standard of care is to provide prophylactic anticoagulation for all hospitalized COVID-19 patients irrespective of other traditional risks for VTE.…”

“…This may be reflected particularly in those admitted to the ICU, where the reported incidence of primarily venous thrombotic complications ranges from 31% to 69% among COVID-19 patients. 3,24,25 A small retrospective study of 49 mechanically ventilated patients from Belgium reported that the use of high-intensity thromboprophylaxis was associated with a lower occurrence of PE. 26 Similarly, a Swedish study of 152 patients demonstrated reduced incidence of thromboembolic events and mortality in those receiving high-dose chemoprophylaxis versus "medium" or "low" (high 13.5% versus medium 25% versus low 38.8%; P = 0.02).…”