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A novel evidence-based algorithm to predict thromboembolism in patients with COVID-19: preliminary data from a single-center cohort.
Ramirez, Giuseppe A; Calvisi, Stefania L; DE Lorenzo, Rebecca; DA Prat, Valentina; Borio, Giorgia; Gallina, Gabriele; Farolfi, Federica; Cavallo, Ludovica; Pascali, Maria; Castellani, Jacopo; Baccellieri, Domenico; Guzzo, Francesca; Baiardo Redaelli, Martina; Azzolini, Maria L; Alba, Ada C; Zangrillo, Alberto; Bozzolo, Enrica P; Scotti, Raffaella; DI Lucca, Giuseppe; Piemonti, Lorenzo; Rovere Querini, Patrizia; D'Angelo, Armando; Tresoldi, Moreno.
  • Ramirez GA; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy.
  • Calvisi SL; Università Vita-Salute San Raffaele, Milan, Italy.
  • DE Lorenzo R; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy - calvisi.stefania@hsr.it.
  • DA Prat V; Università Vita-Salute San Raffaele, Milan, Italy.
  • Borio G; Unit of Internal Medicine and Endocrinology, IRCCS San Raffaele Hospital, Milan, Italy.
  • Gallina G; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Farolfi F; Università Vita-Salute San Raffaele, Milan, Italy.
  • Cavallo L; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Pascali M; Università Vita-Salute San Raffaele, Milan, Italy.
  • Castellani J; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Baccellieri D; Università Vita-Salute San Raffaele, Milan, Italy.
  • Guzzo F; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Baiardo Redaelli M; Università Vita-Salute San Raffaele, Milan, Italy.
  • Azzolini ML; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Alba AC; Università Vita-Salute San Raffaele, Milan, Italy.
  • Zangrillo A; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Bozzolo EP; Università Vita-Salute San Raffaele, Milan, Italy.
  • Scotti R; Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • DI Lucca G; Unit of Vascular Surgery, IRCCS San Raffaele Hospital, Milan, Italy.
  • Piemonti L; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Rovere Querini P; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • D'Angelo A; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Hospital, Milan, Italy.
  • Tresoldi M; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Hospital, Milan, Italy.
Minerva Med ; 113(4): 695-706, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1267020
Semantic information from SemMedBD (by NLM)
1. Thromboembolism PROCESS_OF Patients
Subject
Thromboembolism
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Inflammation COEXISTS_WITH Communicable Diseases
Subject
Inflammation
Predicate
COEXISTS_WITH
Object
Communicable Diseases
4. Disease PREDISPOSES Thrombus
Subject
Disease
Predicate
PREDISPOSES
Object
Thrombus
5. 2019 novel coronavirus PROCESS_OF Patients
Subject
2019 novel coronavirus
Predicate
PROCESS_OF
Object
Patients
6. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
7. Medical History PREDISPOSES Complication
Subject
Medical History
Predicate
PREDISPOSES
Object
Complication
8. Thrombosis PROCESS_OF Patients
Subject
Thrombosis
Predicate
PROCESS_OF
Object
Patients
9. Disseminated Intravascular Coagulation PROCESS_OF Patients
Subject
Disseminated Intravascular Coagulation
Predicate
PROCESS_OF
Object
Patients
10. Thromboembolism PROCESS_OF Patients
Subject
Thromboembolism
Predicate
PROCESS_OF
Object
Patients
11. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
12. Inflammation COEXISTS_WITH Communicable Diseases
Subject
Inflammation
Predicate
COEXISTS_WITH
Object
Communicable Diseases
13. Disease PREDISPOSES Thrombus
Subject
Disease
Predicate
PREDISPOSES
Object
Thrombus
14. 2019 novel coronavirus PROCESS_OF Patients
Subject
2019 novel coronavirus
Predicate
PROCESS_OF
Object
Patients
15. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
16. Medical History PREDISPOSES Complication
Subject
Medical History
Predicate
PREDISPOSES
Object
Complication
17. Thrombosis PROCESS_OF Patients
Subject
Thrombosis
Predicate
PROCESS_OF
Object
Patients
18. Disseminated Intravascular Coagulation PROCESS_OF Patients
Subject
Disseminated Intravascular Coagulation
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-related disease (COVID-19) is an infectious disease characterized by systemic inflammation, which might enhance baseline thrombotic risk, especially in hospitalized patients. Little is, however, known about predictors of thrombotic complications in patients with COVID-19.

METHODS:

We prospectively followed up 180 hospitalized COVID-19 patients. Demographics, clinical and laboratory features at presentation and past medical history were tested as predictors of the first thrombotic complication through multivariate Cox regression analysis and a categorical score generated based on the results.

RESULTS:

Sixty-four thromboses were recorded in 54 patients, of whom seven with thrombosis on admission and 47 with thrombosis during hospitalization. Patients with thrombosis were mainly Caucasian and diabetic, had marked baseline signs of inflammation and organ damage, lower PaO2/FiO2 ratio, higher D-dimer levels and history of major hemorrhages. The latter three variables were independently associated to thrombotic complications and concurred to a 0-5 score, which accounted for 80% of the total sample variability. Patients with three or more points of the newly generated score were at higher risk for thrombotic complications (HR=4.9, P<0.001). Patients with thrombotic complications were more likely to be admitted to intensive care and/or to die (HR=1.9, P=0.036). Five of 180 patients were diagnosed with disseminated intravascular coagulation and three of them died. Eleven minor and no major bleeding events were observed.

CONCLUSIONS:

Patients with COVID-19 are at increased risk for thrombosis and might be stratified on admission based on lower Pao2/FiO2 ratio, higher D-dimer levels and history of major hemorrhages.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Thromboembolism / Thrombosis / COVID-19 Type of study: Etiology study / Observational study / Evidence synthesis / Prognostic study / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: Minerva Med Year: 2022 Document Type: Article Affiliation country: S0026-4806.21.07331-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thromboembolism / Thrombosis / COVID-19 Type of study: Etiology study / Observational study / Evidence synthesis / Prognostic study / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: Minerva Med Year: 2022 Document Type: Article Affiliation country: S0026-4806.21.07331-6