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Pulmonary thromboembolism in coronavirus disease 2019 patients undergoing thromboprophylaxis.
Schiaffino, Simone; Giacomazzi, Francesca; Esseridou, Anastassia; Cozzi, Andrea; Carriero, Serena; Mazzaccaro, Daniela P; Nano, Giovanni; Di Leo, Giovanni; Spagnolo, Pietro; Sardanelli, Francesco.
  • Schiaffino S; Unit of Radiology.
  • Giacomazzi F; Unit of Cardiac Rehabilitation, IRCCS Policlinico San Donato, San Donato Milanese.
  • Esseridou A; Unit of Radiology.
  • Cozzi A; Department of Biomedical Sciences for Health.
  • Carriero S; Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milano.
  • Mazzaccaro DP; Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
  • Nano G; Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
  • Di Leo G; Unit of Radiology.
  • Spagnolo P; Unit of Radiology.
  • Sardanelli F; Unit of Radiology.
Medicine (Baltimore) ; 100(1): e24002, 2021 Jan 08.
Article in English | MEDLINE | ID: covidwho-1024159
ABSTRACT
ABSTRACT We aimed to investigate the prevalence of pulmonary thromboembolism (PTE) and its association with clinical variables in a cohort of hospitalized coronavirus disease 2019 (COVID-19) patients receiving low-molecular-weight heparin (LMWH) at prophylactic dosage.In this retrospective observational study we included COVID-19 patients receiving prophylactic LMWH from admission but still referred for lower-limbs venous Doppler ultrasound (LL-US) and computed tomography pulmonary angiography (CTPA) for clinical PTE suspicion. A dedicated radiologist reviewed CTPA images to assess PTE presence/extension.From March 1 to April 30, 2020, 45 patients were included (34 men, median age 67 years, interquartile range [IQR] 60-76). Twenty-seven (60%) had PTE signs at CTPA, 17/27 (63%) with bilateral involvement, none with main branch PTE. In 33/45 patients (73%) patients LL-US was performed before CTPA, with 3 patients having superficial vein thrombosis (9%, none with CTPA-confirmed PTE) and 1 patient having deep vein thrombosis (3%, with CTPA-confirmed PTE). Thirty-three patients (73%) had at least one comorbidity, mainly hypertension (23/45, 51%) and cardiovascular disease (15/45, 33%). Before CTPA, 5 patients had high D-dimer (11.21 µg/mL, IQR 9.10-13.02), 19 high fibrinogen (550 mg/dL, IQR 476-590), 26 high interleukin-6 (79 pg/mL, IQR 31-282), and 11 high C-reactive protein (9.60 mg/dL, IQR 6.75-10.65), C-reactive protein being the only laboratory parameter significantly differing between patients with and without PTE (P = .002)High PTE incidence (60%) in COVID-19 hospitalized patients under prophylactic LMWH could substantiate further tailoring of anticoagulation therapy.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Embolism / Thrombolytic Therapy / Heparin, Low-Molecular-Weight / COVID-19 / Anticoagulants Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male Language: English Journal: Medicine (Baltimore) Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Embolism / Thrombolytic Therapy / Heparin, Low-Molecular-Weight / COVID-19 / Anticoagulants Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male Language: English Journal: Medicine (Baltimore) Year: 2021 Document Type: Article