Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia

Abstract

Background Three months ago, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) broke out in Wuhan, China, and spread rapidly around the world. Severe novel coronavirus pneumonia (NCP) patients have abnormal blood coagulation function, but their venous thromboembolism (VTE) prevalence is still rarely mentioned. Objectives To determine the incidence of VTE in patients with severe NCP. Methods In this study, 81 severe NCP patients in the intensive care unit (ICU) of Union Hospital (Wuhan, China) were enrolled. The results of conventional coagulation parameters and lower limb vein ultrasonography of these patients were retrospectively collected and analyzed. Results The incidence of VTE in these patients was 25% (20/81), of which 8 patients with VTE events died. The VTE group was different from the non‐VTE group in age, lymphocyte counts, activated partial thromboplastin time (APTT), D‐dimer, etc. If 1.5 µg/mL was used as the D‐dimer cut‐off value to predicting VTE, the sensitivity was 85.0%, the specificity was 88.5%, and the negative predictive value (NPV) was 94.7%. Conclusions The incidence of VTE in patients with severe NCP is 25% (20/81), which may be related to poor prognosis. The significant increase of D‐dimer in severe NCP patients is a good index for identifying high‐risk groups of VTE.

Sex-Specific SARS-CoV-2 Mortality: Among Hormone-Modulated ACE2 Expression, Risk of Venous Thromboembolism and Hypovitaminosis D

“…Another aspect that needs to be highlighted is the increased CVD risk in patients with COVID-19. The prevalence of venous thromboembolism (VTE) in these patients has been reported as 25% and VTE is associated with an unfavorable prognosis [19]. Anticoagulant therapy, mainly with low molecular weight heparin, appears to be associated with a better prognosis in severe COVID-19 patients who have sepsis-induced coagulopathy criteria or markedly elevated D-dimer levels [20].…”

Coagulopathy in COVID-19: Manifestations and management

“…We defi ned a D-dimer at least 6 times the upper limit of normal (3,000 ng/mL fi brinogen equivalent units [FEU]) as the threshold value to defi ne high-risk patients. 5,10 There are currently no data to guide how to address a hypercoagulable pattern on viscoelastic testing (thromboelastography or rotational thromboelastometry). In line with current guidance from the American Society of Hematology (ASH) and the ISTH, we do not routinely use viscoelastic testing to assess hypercoagulability.…”

“…Two recent studies support this clinical impression, reporting a deep vein thrombosis (DVT) rate of 25% 5 and cumulative incidence rates of DVT, pulmonary embolism, and arterial thrombosis of 31% 4 ; and 81% of events reported by Klok et al were pulmonary thromboemboli. 4 In Cleveland Clinic ICUs, we are fi nding that point-of-care ultrasonography (POCUS) detects similar rates of DVT (estimated 25% to 30%) and frequent fi ndings of "slow venous fl ow."…”

Coagulopathy associated with COVID-19

“…In 2 retrospective studies, venous thromboembolism was diagnosed in about 1 in 4 patients admitted to the intensive care unit with COVID-19. 4,5 In 1 study, this occurred despite thromboprophylaxis with low-molecularweight heparin. 5 Available studies have not reported bleeding as a common complication, although the literature is evolving rapidly.…”