Incidence of venous thromboembolism among patients with severe COVID-19 requiring mechanical ventilation compared to other causes of respiratory failure: a prospective cohort study.
J Thromb Thrombolysis
; 52(2): 482-492, 2021 Aug.
Article
in English
| MEDLINE | ID: covidwho-1086634
ABSTRACT
Previous studies have suggested that COVID-19 pneumonia is associated with an increased risk of venous thromboembolism (VTE). This study aimed to investigate the incidence of VTE among mechanically ventilated adults with COVID-19 pneumonia, compared to patients with respiratory failure related to other causes. Prospective study that enrolled critically ill adults with suspected COVID-19 pneumonia between June 2, 2020 and August 11, 2020. Critically ill adults with suspected COVID-19 pneumonia who required mechanical ventilation within 24 h after hospital admission were followed until death or hospital discharge. Sequential ultrasonography screening of the lower extremities and catheter insertion sites, as well as testing for plasma biochemical markers, were performed at the intensive care unit admission, day 3, day 7, and day 14. The primary outcome was a composite of deep venous thrombosis, pulmonary embolism, and thrombosis at the central catheter insertion sites. We enrolled 70 patients, including 57 patients with COVID-19 and 13 patients without COVID-19, and all patients completed follow-up. The incidence of the primary outcome was higher among patients with COVID-19 than among patients with respiratory failure related to other etiologies (36.8% vs. 0%, p = 0.023). Multivariate regression analysis revealed that VTE was independently associated with a COVID-19 diagnosis (odds ratio 6.28, 95% confidence interval 1.19-68.07) and D-dimer concentration (1-ng/mL increase, odds ratio 1.15, 95% confidence interval 1.05-1.30). The incidence of VTE was higher among critically ill mechanically ventilated patients, relative to among patients with respiratory failure related to other causes.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Pulmonary Embolism
/
Respiratory Insufficiency
/
Critical Illness
/
Risk Assessment
/
Venous Thromboembolism
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Etiology study
/
Observational study
/
Prognostic study
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
J Thromb Thrombolysis
Journal subject:
Vascular Diseases
Year:
2021
Document Type:
Article
Affiliation country:
S11239-021-02395-6
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