ABSTRACT
Coronavirus disease 2019 (COVID-19) increases the risk for thromboembolic events, such as acute ischemic stroke (AIS). Mechanical thrombectomy (MT) is a therapy of choice in early diagnosed AIS; however, its success and outcomes in COVID-19 patients are contradictory. This study presented our experience with MT performed in COVID-19 patients compared to a control group. The retrospective analysis included patients with AIS who underwent MT from April 2021 to April 2022 at our institution. There were 13 COVID-19-related patients (with active or past COVID-19 infection) and 55 non-COVID-19 patients (negative COVID-19 status). We analyzed patients' baseline clinical and laboratory data, modified Thrombolysis in Cerebral Infarction (mTICI) scale, used 24 h follow-up CT findings, and modified the Rankin scale. The COVID-19 group had higher values of leukocytes, neutrophils, neutrophil/leukocyte ratios, ASL, ALT, LDH and CRP, and lower values of lymphocytes compared to the control group. The AIS mostly occurred in posterior circulation in the COVID-19 group, while anterior circulation was more affected in the control group. Treatment approach and successful reperfusion did not differ between groups. In conclusion, although differences in some clinical and laboratory parameters between COVID-19 and non-COVID-19 groups were found, the outcomes of mechanical thrombectomy were equal.
ABSTRACT
AIM: To assess the differences in clinical and laboratory parameters of non-hospitalized patients with deep venous thrombosis (DVT) according to the SARS-CoV-2 status. METHODS: We retrospectively reviewed demographic, clinical, laboratory, and ultrasound data of adult patients admitted to the Emergency Department of University Hospital Split between March 2020 and January 2021. Patients were classified into three groups: recent COVID-19 (<1 month), non-recent COVID-19 (1 to 12 months), and non-COVID-19. RESULTS: Fifty (47.2%) of 106 patients had a history of SARS-CoV-2 infection (23 patients in the recent COVID-19 and 27 in non-recent COVID-19 group). The three groups did not significantly differ in demographic and clinical parameters, including the location of deep venous thrombosis. The recent COVID-19 group had significantly higher neutrophils and CRP levels, and significantly lower prothrombin than the other two groups. CONCLUSION: Our results confirm the role of elevated inflammatory and coagulation response in DVT development in the first month after the infection, but not in non-recent COVID-19 or non-COVID-19 patients.
Subject(s)
COVID-19 , Venous Thrombosis , Adult , Humans , COVID-19/complications , Retrospective Studies , SARS-CoV-2 , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology , Risk FactorsABSTRACT
COVID-19 prediction models mostly consist of combined clinical features, laboratory parameters, and, less often, chest X-ray (CXR) findings. Our main goal was to propose a prediction model involving imaging methods, specifically ultrasound. This was a single-center, retrospective cohort observational study of patients admitted to the University Hospital Split from November 2020 to May 2021. Imaging protocols were based on the assessment of 14 lung zones for both lung ultrasound (LUS) and computed tomography (CT), correlated to a CXR score assessing 6 lung zones. Prediction models for the necessity of mechanical ventilation (MV) or a lethal outcome were developed by combining imaging, biometric, and biochemical parameters. A total of 255 patients with COVID-19 pneumonia were included in the study. Four independent predictors were added to the regression model for the necessity of MV: LUS score, day of the illness, leukocyte count, and cardiovascular disease (χ2 = 29.16, p < 0.001). The model accurately classified 89.9% of cases. For the lethal outcome, only two independent predictors contributed to the regression model: LUS score and patient's age (χ2 = 48.56, p < 0.001, 93.2% correctly classified). The predictive model identified four key parameters at patient admission which could predict an adverse outcome.
ABSTRACT
Introduction: Complications of COVID-19 infection have been greatly investigated. The most recent studies found strong association of COVID-19 pneumonia with thromboembolism. The aim of research was to describe clinical and computed tomography pulmonary angiograms (CTPA) characteristics of COVID-19 related pulmonary artery thromboembolism (PE). Methods: All consecutive CTPA with positive PE in COVID-19 patients from University Hospital Split, from March 23, 2020 to January 31, 2021 were analyzed. Baseline data were collected from patient's electronic records. CTPA scan analysis identified PE anatomical location (i.e., main, lobar, segmental, or subsegmental). Results: A total number of 78 positive CTPA in COVID-19 patients was mainly in elderly with several co-morbidities, high D-dimer levels, at median of 14 days. CTPAs showed involvement of the entire pulmonary artery tree, mainly of the small-to medium diameter pulmonary artery branches, unilaterally (n = 31, 39,74%), and bilaterally (n = 33, 42.31%). The large-diameter branches were the most rarely affected as a single location (n = 14, 17.95%). Conclusion: PE occurred in predominantly elderly people, having several comorbidities, and high D-dimer levels. Embolic involvement of pulmonary branches of all sizes were found, the most frequent of small to medium diameter branches. Further investigation is needed to better understand mechanisms and course of the COVID-19 related PE.