Logo image
Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China: Prevalence, Risk Factors, and Outcome
Journal article   Open access

Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China: Prevalence, Risk Factors, and Outcome

Li Zhang, Xiaokai Feng, Danqing Zhang, Chunguo Jiang, Heng Mei, Jing Wang, Cuihong Zhang, Hong Li, Xiaoling Xia, Shuangshuang Kong, …
Circulation (New York, N.Y.), v 142(2), pp 114-128
14 Jul 2020
PMID: 32421381
url
https://doi.org/10.1161/circulationaha.120.046702View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Adult Aged Anticoagulants - therapeutic use Betacoronavirus - isolation & purification Blood Pressure China - epidemiology Coronavirus Infections - complications Coronavirus Infections - diagnosis Coronavirus Infections - mortality Coronavirus Infections - physiopathology COVID-19 Female Fibrin Fibrinogen Degradation Products - analysis Humans Kaplan-Meier Estimate Lower Extremity - diagnostic imaging Male Middle Aged Odds Ratio Pandemics Pneumonia, Viral - complications Pneumonia, Viral - diagnosis Pneumonia, Viral - mortality Pneumonia, Viral - physiopathology Prevalence Prognosis Respiratory Rate Retrospective Studies Risk Factors SARS-CoV-2 Treatment Outcome Venous Thrombosis - complications Venous Thrombosis - diagnosis Venous Thrombosis - drug therapy Venous Thrombosis - epidemiology ESI Highly Cited Paper (Incites)
To investigate deep vein thrombosis (DVT) in hospitalized patients with coronavirus disease 2019 (COVID-19), we performed a single institutional study to evaluate its prevalence, risk factors, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center. We studied a total of 143 patients with COVID-19 from January 29, 2020 to February 29, 2020. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities, and outcome variables were obtained, and comparisons were made between groups with and without DVT. Of the 143 patients hospitalized with COVID-19 (age 63±14 years, 74 [51.7%] men), 66 patients developed lower extremity DVT (46.1%: 23 [34.8%] with proximal DVT and 43 [65.2%] with distal DVT). Compared with patients who did not have DVT, patients with DVT were older and had a lower oxygenation index, a higher rate of cardiac injury, and worse prognosis, including an increased proportion of deaths (23 [34.8%] versus 9 [11.7%]; =0.001) and a decreased proportion of patients discharged (32 [48.5%] versus 60 [77.9%]; <0.001). Multivariant analysis showed an association only between CURB-65 (confusion status, urea, respiratory rate, and blood pressure) score 3 to 5 (odds ratio, 6.122; =0.031), Padua prediction score ≥4 (odds ratio, 4.016; =0.04), D-dimer >1.0 μg/mL (odds ratio, 5.818; <0.014), and DVT in this cohort, respectively. The combination of a CURB-65 score 3 to 5, a Padua prediction score ≥4, and D-dimer >1.0 μg/mL has a sensitivity of 88.52% and a specificity of 61.43% for screening for DVT. In the subgroup of patients with a Padua prediction score ≥4 and whose ultrasound scans were performed >72 hours after admission, DVT was present in 18 (34.0%) patients in the subgroup receiving venous thromboembolism prophylaxis versus 35 (66.0%) patients in the nonprophylaxis group ( =0.010). The prevalence of DVT is high and is associated with adverse outcomes in hospitalized patients with COVID-19. Prophylaxis for venous thromboembolism may be protective in patients with a Padua protection score ≥4 after admission. Our data seem to suggest that COVID-19 is probably an additional risk factor for DVT in hospitalized patients.

Metrics

9 Record Views
367 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Highly Cited Paper 
Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Peripheral Vascular Disease
Logo image