Journal article
Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China: Prevalence, Risk Factors, and Outcome
Circulation (New York, N.Y.), v 142(2), pp 114-128
14 Jul 2020
PMID: 32421381
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
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Details
- Title
- Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China: Prevalence, Risk Factors, and Outcome
- Creators
- Li Zhang - Huazhong University of Science and TechnologyXiaokai Feng - Beijing Chao-Yang HospitalDanqing Zhang - Huazhong University of Science and TechnologyChunguo Jiang - Beijing Chao-Yang HospitalHeng Mei - Huazhong University of Science and TechnologyJing Wang - Huazhong University of Science and TechnologyCuihong Zhang - Huazhong University of Science and TechnologyHong Li - Huazhong University of Science and TechnologyXiaoling Xia - Huazhong University of Science and TechnologyShuangshuang Kong - Huazhong University of Science and TechnologyJia Liao - Huazhong University of Science and TechnologyHuijun Jia - Huazhong University of Science and TechnologyXueqin Pang - Huazhong University of Science and TechnologyYue Song - Huazhong University of Science and TechnologyYing Tian - Huazhong University of Science and TechnologyBin Wang - Huazhong University of Science and TechnologyChun Wu - Huazhong University of Science and TechnologyHongliang Yuan - Huazhong University of Science and TechnologyYongxing Zhang - Huazhong University of Science and TechnologyYuman Li - Huazhong University of Science and TechnologyWei Sun - Huazhong University of Science and TechnologyYanting Zhang - Huazhong University of Science and TechnologyShuangshuang Zhu - Huazhong University of Science and TechnologyShuyuan Wang - Huazhong University of Science and TechnologyYuji Xie - Huazhong University of Science and TechnologyShuping Ge - St. Christopher's Hospital for ChildrenLiming Zhang - Beijing Chao-Yang HospitalYu Hu - Huazhong University of Science and TechnologyMingxing Xie - Huazhong University of Science and Technology
- Publication Details
- Circulation (New York, N.Y.), v 142(2), pp 114-128
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000559794900012
- Scopus ID
- 2-s2.0-85086738168
- Other Identifier
- 991019167569404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Peripheral Vascular Disease