Unexpected Pulmonary Embolism Late After Recovery from Mild COVID-19?

Pace, Doranna De; Ariotti, Sara; Persampieri, Simone; Patti, Giuseppe; Alessandro, Lupi

doi:10.12890/2021_002854

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Currently, guidelines as well as experts’ opinions recommend the use of standard VTE thromboprophylaxis in all hospitalized patients who do not have suspected or confirmed VTE [ 5 , 6 , 7 ]. Nevertheless, many reports and investigations showed that a variable risk of COVID-19-associated VTE extends over the first 3 months after hospital discharge, but the cumulative incidence of such events has not been clearly determined [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. In this context, the American Society of Hematology (ASH) updated 2021 guidelines do not recommend extended anticoagulation in the COVID-19 patients discharged from the hospital, who do not have suspected or confirmed VTE, or another indication for anticoagulation [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

Symptomatic Venous Thromboembolic Events in COVID-19 Patients after Hospital Discharge: Aspects to Consider

Pop¹,

Moș²,

Cotoraci³

2022

Rev. Cardiovasc. Med.

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Venous thromboembolic (VTE) events have been increasingly reported in patients with coronavirus disease 2019 (COVID-19) after hospital discharge. Acute pulmonary embolism (PE) is the most frequent type of post-discharge VTE complication. Levels of procoagulants (fibrinogen, factor VIII, von Willebrand factor), and D-dimer are higher during the SARS-CoV-2 infection. Patients with more severe inflammatory and procoagulant response experience higher VTE rates during hospitalization, while the risk after hospital discharge have not been well characterized. The incidence of VTE events following hospitalization is heterogeneous, ranging from low (3.1 per 1000 discharges), to 1.8%, which appears higher than for other medical condition. This discrepancy was partially explained by the differences in VTE screening and follow-up strategies, and by the period when the information about the VTE was collected. These data were based mainly on observational and retrospective studies; however, evolving data are to come after the completion of the prospective trials. The current guidelines do not recommend routine post-hospital VTE prophylaxis for COVID-19 patients but recommend it for all hospitalized adults. A careful risk-benefit assessment of VTE probability should be performed, to determine whether an individual patient may merit post-discharge thromboprophylaxis. A score such IMPROVE DD can help identify the patient who will potentially benefit but is also important to consider the bleeding risk and the feasibility. The optimal duration and the type of extended thromboprophylaxis is still under debate (from a minimum of 14 days to a maximum of 42 days), and future studies will help to validate these protocols in different populations. Direct oral anticoagulants (DOACs), warfarin and low molecular weight heparin (LMWH) are recommended, but low doses of DOACs rather than LMVH or warfarin were predominantly used in most patients. Finally, the COVID-19 patients should be educated to recognize and advised to seek urgent medical care should VTE events occur after hospital discharge.

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Section: Introductionmentioning

confidence: 99%

Symptomatic Venous Thromboembolic Events in COVID-19 Patients after Hospital Discharge: Aspects to Consider

Pop¹,

Moș²,

Cotoraci³

2022

Rev. Cardiovasc. Med.

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Pulmonary Embolism in Post-CoviD-19 Patients, a Literature Review: Red Flag for Increased Awareness?

Mouzarou

Ιωάννου

Leonidou

et al. 2022

SN Compr. Clin. Med.

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Although COVID-19 was primarily considered a respiratory illness, rapidly accumulating data suggest that COVID-19 is associated with a high incidence of venous thromboembolic complications. The primary objective of this review article was to reveal whether we need to increase awareness of pulmonary embolism in the period following the COVID-19 infection given that the epidemiologic facts are still poor. A literature search and a critical review of the collected studies were conducted. An electronic search of PubMed, Science Direct Scopus, Google Scholar, and Excerpta Medica Database (EMBASE) from June 2020 until June 2022. The long-term health consequences of COVID-19 remain largely unclear. This review highlights the importance of awareness of the potentially increased incidence of venous thromboembolism in post-COVID-19 patients, even those with mild or asymptomatic disease. Further research is required to establish appropriate clinical management guidelines for the prevention of thromboembolic complications in the post-COVID-19 period. Keywords Pulmonary embolism • Post-COVID-19 • Thromboembolic eventsThis article is part of the Topical Collection on Covid-19

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Readmission After COVID-19 for Late Acute Venous Thrombosis; CASE SERIES and Systematic Review of the Literature

Gutiérrez

McQuary

González-Urquijo

et al. 2023

Vasc Endovascular Surg

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Objective Assess heterogeneity within patients with resolved COVID-19 to broaden the vision about post-discharge thrombotic cases and postulate possible related mechanisms in search of better anticoagulation guidelines. This study details patients’ characteristics, medical history, treatment, and outcomes of readmitted patients with late acute thrombosis through a systematic review of the literature and patients from our academic center database. Methods We extracted the records of patients readmitted for venous thrombosis complications after discharge from the database of the first 2000 patients admitted with COVID-19 in our academic center; we also performed a systematic review of the literature using the Medical Subject Headings terms “late thrombosis,” “COVID-19,” + “venous thrombosis” in PubMed and Google Scholar according to PRISMA guideline. Results The literature review found 20 patients suitable for review matching the inclusion criteria. These patients were added to those in our database, summing up a total of 26 patients. The median age was 50 years old, 76.9% were male, and most were overweight or had grade 1 obesity (n = 11, 42.3%). None had a previous thrombotic history, but 50% had an underlying comorbidity. Thrombotic events presented on a median of 20 days (range: 4-150 days) from discharge. Pulmonary embolisms occurred in 23 patients (88.46%), deep vein thrombosis in 4, mesenteric thrombosis, and cerebral venous thrombosis in 1, respectively. Conclusion This study found that most patients readmitted for thrombotic events after COVID-19 discharge were middle-aged men with Venous Thrombo Embolism events.

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Unexpected Pulmonary Embolism Late After Recovery from Mild COVID-19?

Cited by 3 publications

References 19 publications

Symptomatic Venous Thromboembolic Events in COVID-19 Patients after Hospital Discharge: Aspects to Consider

Symptomatic Venous Thromboembolic Events in COVID-19 Patients after Hospital Discharge: Aspects to Consider

Pulmonary Embolism in Post-CoviD-19 Patients, a Literature Review: Red Flag for Increased Awareness?

Readmission After COVID-19 for Late Acute Venous Thrombosis; CASE SERIES and Systematic Review of the Literature

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