Li, Jun-Ying, Wang, Hong-Fei, Yin, Ping, Li, Di, Wang, Di-Le, Peng, Peng, Wang, Wei-Hua, Wang, Lan, Yuan, Xiao-Wei, Xie, Jin-Yuan et al (show 13 more authors)
(2021)
Clinical characteristics and risk factors for symptomatic venous thromboembolism in hospitalized COVID-19 patients: A multicenter retrospective study.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 19 (4).
pp. 1038-1048.
Text
Clinical characteristics and risk factors for symptomatic VTE inhospitalized COVID-19 gl20200531.docx - Author Accepted Manuscript Download (3MB) |
Abstract
<h4>Background</h4>High incidence of asymptomatic venous thromboembolism (VTE) has been observed in severe COVID-19 patients, but the characteristics of symptomatic VTE in general COVID-19 patients have not been described.<h4>Objectives</h4>To comprehensively explore the prevalence and reliable risk prediction for VTE in COVID-19 patients.<h4>Methods/results</h4>This retrospective study enrolled all COVID-19 patients with a subsequent VTE in 16 centers in China from January 1 to March 31, 2020. A total of 2779 patients were confirmed with COVID-19. In comparison to 23,434 non-COVID-19 medical inpatients, the odds ratios (ORs) for developing symptomatic VTE in severe and non-severe hospitalized COVID-19 patients were 5.94 (95% confidence interval [CI] 3.91-10.09) and 2.79 (95% CI 1.43-5.60), respectively. When 104 VTE cases and 208 non-VTE cases were compared, pulmonary embolism cases had a higher rate for in-hospital death (OR 6.74, 95% CI 2.18-20.81). VTE developed at a median of 21 days (interquartile range 13.25-31) since onset. Independent factors for VTE were advancing age, cancer, longer interval from symptom onset to admission, lower fibrinogen and higher D-dimer on admission, and D-dimer increment (DI) ≥1.5-fold; of these, DI ≥1.5-fold had the most significant association (OR 14.18, 95% CI 6.25-32.18, p = 2.23 × 10<sup>-10</sup> ). A novel model consisting of three simple coagulation variables (fibrinogen and D-dimer levels on admission, and DI ≥1.5-fold) showed good prediction for symptomatic VTE (area under the curve 0.865, 95% CI 0.822-0.907, sensitivity 0.930, specificity 0.710).<h4>Conclusions</h4>There is an excess risk of VTE in hospitalized COVID-19 patients. This novel model can aid early identification of patients who are at high risk for VTE.
Item Type: | Article |
---|---|
Uncontrolled Keywords: | COVID-19, D-dimer increment, SARS-CoV-2, thrombosis, venous thromboembolism |
Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
Depositing User: | Symplectic Admin |
Date Deposited: | 18 Mar 2021 08:16 |
Last Modified: | 04 Jul 2023 15:11 |
DOI: | 10.1111/jth.15261 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3117644 |