D-dimer cut-off points and risk of venous thromboembolism in adult hospitalized patients with COVID-19.

Published on Sep 17, 2020in Thrombosis Research2.869
· DOI :10.1016/J.THROMRES.2020.09.022
Justin J. Choi15
Estimated H-index: 15
(NewYork–Presbyterian Hospital),
Graham T Wehmeyer3
Estimated H-index: 3
(Cornell University)
+ 16 AuthorsMaria T. DeSancho13
Estimated H-index: 13
(NewYork–Presbyterian Hospital)
Coronavirus Disease 2019 (COVID-19) pandemic is a rapidly evolving public health problem. The severity of COVID-19 cases reported hitherto has varied greatly from asymptomatic to severe pneumonia and thromboembolism with subsequent mortality. An improved understanding of risk factors for adverse clinical outcomes may shed some light on novel personalized approaches to optimize clinical care in vulnerable populations. Emerging trends in the United States suggest possibly higher mortality rates of...
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#1Maxime G. Zermatten (UNIL: University of Lausanne)H-Index: 6
#2Olivier Pantet (UNIL: University of Lausanne)H-Index: 12
Last. Lorenzo Alberio (UNIL: University of Lausanne)H-Index: 25
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#1Angelo Porfidia (UCSC: Catholic University of the Sacred Heart)H-Index: 7
#2Emanuele Valeriani (Sapienza University of Rome)H-Index: 8
Last. Marcello Di NisioH-Index: 34
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Abstract Background Venous thromboembolism (VTE) may complicate the course of Coronavirus Disease 2019 (COVID-19). Objectives To evaluate the incidence of VTE in patients with COVID-19. Methods MEDLINE, EMBASE, and PubMed were searched up to 24th June 2020 for studies that evaluated the incidence of VTE, including pulmonary embolism (PE) and/or deep vein thrombosis (DVT), in patients with COVID-19. Pooled proportions with corresponding 95% confidence intervals (CI) and prediction intervals (PI) ...
54 CitationsSource
#1Hanny Al-Samkari (Harvard University)H-Index: 16
#2Rebecca Karp Leaf (Harvard University)H-Index: 11
Last. Rachel P. Rosovsky (Harvard University)H-Index: 20
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Patients with coronavirus disease 2019 (COVID-19) have elevated D-dimer levels. Early reports describe high venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC) rates, but data are limited. This multicenter, retrospective study described the rate and severity of hemostatic and thrombotic complications of 400 hospital-admitted COVID-19 patients (144 critically ill) primarily receiving standard-dose prophylactic anticoagulation. Coagulation and inflammatory parameters were...
378 CitationsSource
#1Julien PoissyH-Index: 19
#2Julien GoutayH-Index: 4
Last. Sophie Susen (Lille University of Science and Technology)H-Index: 1
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568 CitationsSource
#1Songping Cui (Capital Medical University)H-Index: 1
#2Shuo Chen (Capital Medical University)H-Index: 1
Last. Feng WangH-Index: 1
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BACKGROUND: Since 3 months ago, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out in Wuhan, China, and spread rapidly around the world. Severe novel coronavirus pneumonia (NCP) patients have abnormal blood coagulation function, but their venous thromboembolism(VTE) prevalence is still rarely mentioned. OBJECTIVES: To determine the incidence of VTE in patients with severe NCP. METHODS: In this study, 81 severe NCP patients in the Intensive Care Unit (ICU) of Union Hospital (W...
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#1Ian Leonard-LorantH-Index: 6
#2Xavier DelabrancheH-Index: 13
Last. Mickaël OhanaH-Index: 18
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Thirty-two of 106 patients (30% [95% confidence interval: 22%, 40%]) with coronavirus disease 2019 infection were positive for acute pulmonary embolus on pulmonary CT angiograms.
303 CitationsSource
#1Frederikus A. Klok (LUMC: Leiden University Medical Center)H-Index: 51
#2Marieke J. H. A. Kruip (Erasmus University Medical Center)H-Index: 26
Last. Henrik Endeman (EUR: Erasmus University Rotterdam)H-Index: 20
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Abstract Introduction COVID-19 may predispose to both venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilisation and diffuse intravascular coagulation. Reports on the incidence of thrombotic complications are however not available. Methods We evaluated the incidence of the composite outcome of symptomatic acute pulmonary embolism (PE), deep-vein thrombosis, ischemic stroke, myocardial infarction or systemic arterial embolism in all COVID-19 patients admitted to th...
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#1Fei Zhou (Peking Union Medical College)H-Index: 5
#1Fei Zhou (Peking Union Medical College)H-Index: 7
Last. Bin CaoH-Index: 21
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BackgroundSince December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described.
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Studies often suggest that accepted clinical predictors actually have little predictive strength. One explanation for some such results is the presence of workup bias. To explore the effects of workup bias in prediction research, the authors modeled the effects of workup bias on the ability of early clinical findings to predict intracerebral hemorrhage in patients with stroke. In a simulated biased sample, workup bias resulted in distorted operating characteristics for those clinical findings in...
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Cited By17
#1Samuel J Elberts (Thomas Jefferson University Hospital)
#2Ryan Bateman (Thomas Jefferson University Hospital)
Last. J. Matthew Fields (Thomas Jefferson University Hospital)H-Index: 16
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Objective null This study seeks to evaluate the test characteristics of D-dimer for pulmonary embolism (PE) in patients with a concurrent diagnosis of COVID-19. We hypothesized that the sensitivity of D-dimer for PE at current institutional cut points would be similar to those without COVID-19. null Methods null This is a multicenter retrospective observational cohort study across five urban and suburban EDs in the same health care system. The electronic health record was queried for all compute...
#1Liyan Cui (JNU: Jinan University)H-Index: 1
#2Wenwen Cheng (JNU: Jinan University)H-Index: 1
Last. Zhuoming Chen (JNU: Jinan University)H-Index: 1
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Abstract null null Purpose null To detect the risk factors for pulmonary embolism (PE) in patients with COVID-19. null null null Methods null We searched for studies in PubMed, Cochrane Library, Web of Science, and EMBASE. Two authors independently screened articles and extracted data. The data were pooled by meta-analysis, and three subgroup analyses were performed. null null null Results null Of the 2210 articles identified, 27 studies were included. Pooled analysis suggested that males (odds ...
Venous thromboembolic complications have emerged as serious sequelae in COVID-19 infections. This article summarizes the most current information regarding pathophysiology, risk factors and hematologic markers, incidence and timing of events, atypical venous thromboembolic complications, prophylaxis recommendations, and therapeutic recommendations. Data will likely to continue to rapidly evolve as more knowledge is gained regarding venous events in COVID-19 patients. © 2021 Elsevier Inc.
#1Sadjad Riyahi (Cornell University)H-Index: 1
#2Hreedi Dev (Cornell University)H-Index: 1
Last. Anas Bamashmos (Yale University)
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Background Pulmonary embolism (PE) commonly complicates SARS-CoV-2 infection but there is heterogeneity in incidence and mortality in the single center reports and risk factors. Purpose To determine the incidence of PE in COVID-19 and its associations with clinical and laboratory parameters. Methods Electronic medical records were searched retrospectively for demographic, clinical and laboratory data and outcomes in patients admitted with COVID-19 at 4 hospitals March-June 2020. PE on CT pulmona...
#1Eman M. Mansory (UWO: University of Western Ontario)
#2Suthan Srigunapalan (UWO: University of Western Ontario)
Last. Alejandro Lazo-Langner (UWO: University of Western Ontario)H-Index: 24
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Introduction Venous thromboembolism (VTE) has been observed as a frequent complication in patients with severe novel coronavirus disease 2019 (COVID-19) infection requiring hospital admission. Aim This study was aimed to evaluate the epidemiology of VTE in hospitalized intensive care unit (ICU) and non-ICU patients. Materials and Methods PubMed was searched up to November 13, 2020, and updated in December 12, 2020. We included studies that evaluated the epidemiology of VTE, including pulmonary e...
#1Milou Anne Maria Stals (LUMC: Leiden University Medical Center)
#2F.H.J. Kaptein (LUMC: Leiden University Medical Center)H-Index: 3
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Accumulating studies on COVID-19 patients report high incidences of thrombotic complications, but guidance on the best diagnostic approach for suspected pulmonary embolism (PE) in COVID-19 patients is lacking. Diagnosing PE in these patients is challenging as signs and symptoms of PE and COVID-19 show wide overlap, D-dimer levels are often elevated in the absence of thrombosis and computed tomography pulmonary angiography (CTPA) may be unfeasible in the case of severe renal impairment and/or hem...
Introduction: D-dimer levels are elevated in COVID 19 and they correlate to the levels of other inflammatory markers such us ferritin, fibrinogen and C-reactive protein null It may be possible to correct D-dimer value in function of inflammatory markers, thus identifying patients at higher risk of venous thromboembolism (VTE) null Our objectives are estimating a corrected value of plasma D-dimer as a linear function of ferritin, C-reactive protein and fibrinogen and stablishing a cut-off point o...
#1David R. Price (NewYork–Presbyterian Hospital)H-Index: 6
#2Elisa Benedetti (Cornell University)H-Index: 4
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Vascular injury is a menacing element of acute respiratory distress syndrome (ARDS) pathogenesis. To better understand the role of vascular injury in COVID-19 ARDS, we used lung autopsy immunohistochemistry and blood proteomics from COVID-19 subjects at distinct timepoints in disease pathogenesis, including a hospitalized cohort at risk of ARDS development ("at risk", N=59), an intensive care unit cohort with ARDS ("ARDS", N=31), and a cohort recovering from ARDS ("recovery", N=12). COVID-19 ARD...
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The incidence of pulmonary embolism (PE) is high during severe Coronavirus Disease 2019 (COVID-19). We aimed to identify predictive and prognostic factors of PE in non-ICU hospitalized COVID-19 patients. In the retrospective multicenter observational CLOTVID cohort, we enrolled patients with confirmed RT-PCR COVID-19 who were hospitalized in a medicine ward and also underwent a CT pulmonary angiography for a PE suspicion. Baseline data, laboratory biomarkers, treatments, and outcomes were collec...
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