History of COVID-19 infection is not associated with increased d-dimer levels and risk of deep-vein thrombosis in total joint arthroplasty
Introduction In the acute phase of COVID-19, elevated d -dimer levels indicate a hypercoagulable state putting the patients at increased risk for venous thromboembolic disease (VTE). It is unclear, if prior COVID-19 disease increases the risk for VTE after total joint arthroplasty (TJA) and if d -di...
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description | Introduction
In the acute phase of COVID-19, elevated
d
-dimer levels indicate a hypercoagulable state putting the patients at increased risk for venous thromboembolic disease (VTE). It is unclear, if prior COVID-19 disease increases the risk for VTE after total joint arthroplasty (TJA) and if
d
-dimer levels can be used to identify patients at risk.
Materials and methods
d
-Dimer levels of 313 consecutive SARS-CoV-2 IgG-positive and 2,053 -negative patients undergoing TJA between 05/20 and 12/20 were evaluated.
d
-Dimer levels were divided into three groups: 400 ng/ml
d
-dimer units (DDU). 277 SARS-CoV-2 IgG-positive patients underwent a Doppler ultrasound to rule out deep-vein thrombosis (DVT) 4–6 weeks after TJA.
Results
d
-Dimer levels did not differ significantly between SARS-CoV-2 IgG-positive and -negative patients (
p
value 0.53). Among SARS-CoV-2 IgG-negative patients, 1687 (82.17%) had
d
-dimer levels 400 ng/ml. Of the SARS-CoV-2 IgG-positive patients, 257 (83.71%) had
d
-dimer levels 400 ng/ml. A postoperative DVT was detected in nine patients (2.9%) in the SARS-CoV-2 IgG-positive group and a PE in one patient (0.3%). 7/229 patients with 400 ng/ml had a DVT or PE (
p
= 0.43).
Conclusions
The findings of this investigation suggest there is no difference in
d
-dimer levels between SARS-CoV-2 IgG-positive and -negative patients undergoing TJA. Although there is a trend for increased VTE rates with increased
d
-dimer levels, routine
d
-dimer testing is not recommended based on the current data. SARS-CoV-2 IgG-positive patients have a low risk of VTE in the current study. |
doi_str_mv | 10.1007/s00402-021-04181-8 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8453476</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2575070671</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-b996db15085a8759d7305dfa75301db6c06e264b75ebff3930eadfe9fd10ad53</originalsourceid><addsrcrecordid>eNp9kU1vEzEQhlcIREvhD3BAlrhwMYy_1rsXJBQ-WqlSLxVXy7uebRw2drCdVPkL_GocUkrhwMkezTOPPXqb5iWDtwxAv8sAEjgFzihI1jHaPWpOmRSSip61jx_cT5pnOa8AGO96eNqcCKlkKzk_bX6c-1xi2pM4kcXV14uPlPXEhwnH4mMgPpMQC7E5x9Hbgo7c-rKswJjQ5lo66vwaE5lxh3MmNjiSfP520DnEDd2hD6QsU1wPMVfboYrFzmQVfajidOhtZpvL_nnzZLJzxhd351lz_fnT9eKcXl59uVh8uKSj1LLQoe9bNzAFnbKdVr3TApSbrFYCmBvaEVrkrRy0wmGaRC8ArZuwnxwD65Q4a94ftZvtsEY3YijJzmaT_NqmvYnWm787wS_NTdyZTiohdVsFb-4EKX7fYi5m7fOI82wDxm02XGkFGlrNKvr6H3QVtynU7QzXWnVSdFxXih-pMcWcE073n2FgDkmbY9KmJm1-JW26OvTq4Rr3I7-jrYA4Arm2wg2mP2__R_sTyey2dQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2775843827</pqid></control><display><type>article</type><title>History of COVID-19 infection is not associated with increased d-dimer levels and risk of deep-vein thrombosis in total joint arthroplasty</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Jungwirth-Weinberger, Anna ; Bendich, Ilya ; Hanreich, Carola ; Gonzalez Della Valle, Alejandro ; Blevins, Jason L. ; Westrich, Geoffrey H. ; Boettner, Friedrich</creator><creatorcontrib>Jungwirth-Weinberger, Anna ; Bendich, Ilya ; Hanreich, Carola ; Gonzalez Della Valle, Alejandro ; Blevins, Jason L. ; Westrich, Geoffrey H. ; Boettner, Friedrich</creatorcontrib><description>Introduction
In the acute phase of COVID-19, elevated
d
-dimer levels indicate a hypercoagulable state putting the patients at increased risk for venous thromboembolic disease (VTE). It is unclear, if prior COVID-19 disease increases the risk for VTE after total joint arthroplasty (TJA) and if
d
-dimer levels can be used to identify patients at risk.
Materials and methods
d
-Dimer levels of 313 consecutive SARS-CoV-2 IgG-positive and 2,053 -negative patients undergoing TJA between 05/20 and 12/20 were evaluated.
d
-Dimer levels were divided into three groups: < 200 ng/ml, 200–400 ng/ml, and > 400 ng/ml
d
-dimer units (DDU). 277 SARS-CoV-2 IgG-positive patients underwent a Doppler ultrasound to rule out deep-vein thrombosis (DVT) 4–6 weeks after TJA.
Results
d
-Dimer levels did not differ significantly between SARS-CoV-2 IgG-positive and -negative patients (
p
value 0.53). Among SARS-CoV-2 IgG-negative patients, 1687 (82.17%) had
d
-dimer levels < 200 ng/ml, 256 (12.47%) between 200 and 400 ng/ml, and 110 (5.36%) > 400 ng/ml. Of the SARS-CoV-2 IgG-positive patients, 257 (83.71%) had
d
-dimer levels < 200 ng/ml, 34 (11.07%) between 200 and 400 ng/ml, and 16 (5.21%) > 400 ng/ml. A postoperative DVT was detected in nine patients (2.9%) in the SARS-CoV-2 IgG-positive group and a PE in one patient (0.3%). 7/229 patients with < 200 ng/ml (3.1%), 1/28 patients (3.6%) with 200–400 ng/ml and 1/9 patients (11.1%) with
d
-dimer levels > 400 ng/ml had a DVT or PE (
p
= 0.43).
Conclusions
The findings of this investigation suggest there is no difference in
d
-dimer levels between SARS-CoV-2 IgG-positive and -negative patients undergoing TJA. Although there is a trend for increased VTE rates with increased
d
-dimer levels, routine
d
-dimer testing is not recommended based on the current data. SARS-CoV-2 IgG-positive patients have a low risk of VTE in the current study.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-021-04181-8</identifier><identifier>PMID: 34546422</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arthroplasty - adverse effects ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; Humans ; Joint surgery ; Medicine ; Medicine & Public Health ; Orthopaedic Surgery ; Orthopedics ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Thrombosis ; Venous Thromboembolism - etiology ; Venous Thrombosis - etiology</subject><ispartof>Archives of orthopaedic and trauma surgery, 2023-02, Vol.143 (2), p.785-789</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-b996db15085a8759d7305dfa75301db6c06e264b75ebff3930eadfe9fd10ad53</citedby><cites>FETCH-LOGICAL-c474t-b996db15085a8759d7305dfa75301db6c06e264b75ebff3930eadfe9fd10ad53</cites><orcidid>0000-0002-7906-9486</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-021-04181-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-021-04181-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34546422$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jungwirth-Weinberger, Anna</creatorcontrib><creatorcontrib>Bendich, Ilya</creatorcontrib><creatorcontrib>Hanreich, Carola</creatorcontrib><creatorcontrib>Gonzalez Della Valle, Alejandro</creatorcontrib><creatorcontrib>Blevins, Jason L.</creatorcontrib><creatorcontrib>Westrich, Geoffrey H.</creatorcontrib><creatorcontrib>Boettner, Friedrich</creatorcontrib><title>History of COVID-19 infection is not associated with increased d-dimer levels and risk of deep-vein thrombosis in total joint arthroplasty</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
In the acute phase of COVID-19, elevated
d
-dimer levels indicate a hypercoagulable state putting the patients at increased risk for venous thromboembolic disease (VTE). It is unclear, if prior COVID-19 disease increases the risk for VTE after total joint arthroplasty (TJA) and if
d
-dimer levels can be used to identify patients at risk.
Materials and methods
d
-Dimer levels of 313 consecutive SARS-CoV-2 IgG-positive and 2,053 -negative patients undergoing TJA between 05/20 and 12/20 were evaluated.
d
-Dimer levels were divided into three groups: < 200 ng/ml, 200–400 ng/ml, and > 400 ng/ml
d
-dimer units (DDU). 277 SARS-CoV-2 IgG-positive patients underwent a Doppler ultrasound to rule out deep-vein thrombosis (DVT) 4–6 weeks after TJA.
Results
d
-Dimer levels did not differ significantly between SARS-CoV-2 IgG-positive and -negative patients (
p
value 0.53). Among SARS-CoV-2 IgG-negative patients, 1687 (82.17%) had
d
-dimer levels < 200 ng/ml, 256 (12.47%) between 200 and 400 ng/ml, and 110 (5.36%) > 400 ng/ml. Of the SARS-CoV-2 IgG-positive patients, 257 (83.71%) had
d
-dimer levels < 200 ng/ml, 34 (11.07%) between 200 and 400 ng/ml, and 16 (5.21%) > 400 ng/ml. A postoperative DVT was detected in nine patients (2.9%) in the SARS-CoV-2 IgG-positive group and a PE in one patient (0.3%). 7/229 patients with < 200 ng/ml (3.1%), 1/28 patients (3.6%) with 200–400 ng/ml and 1/9 patients (11.1%) with
d
-dimer levels > 400 ng/ml had a DVT or PE (
p
= 0.43).
Conclusions
The findings of this investigation suggest there is no difference in
d
-dimer levels between SARS-CoV-2 IgG-positive and -negative patients undergoing TJA. Although there is a trend for increased VTE rates with increased
d
-dimer levels, routine
d
-dimer testing is not recommended based on the current data. SARS-CoV-2 IgG-positive patients have a low risk of VTE in the current study.</description><subject>Arthroplasty - adverse effects</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopaedic Surgery</subject><subject>Orthopedics</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Thrombosis</subject><subject>Venous Thromboembolism - etiology</subject><subject>Venous Thrombosis - etiology</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kU1vEzEQhlcIREvhD3BAlrhwMYy_1rsXJBQ-WqlSLxVXy7uebRw2drCdVPkL_GocUkrhwMkezTOPPXqb5iWDtwxAv8sAEjgFzihI1jHaPWpOmRSSip61jx_cT5pnOa8AGO96eNqcCKlkKzk_bX6c-1xi2pM4kcXV14uPlPXEhwnH4mMgPpMQC7E5x9Hbgo7c-rKswJjQ5lo66vwaE5lxh3MmNjiSfP520DnEDd2hD6QsU1wPMVfboYrFzmQVfajidOhtZpvL_nnzZLJzxhd351lz_fnT9eKcXl59uVh8uKSj1LLQoe9bNzAFnbKdVr3TApSbrFYCmBvaEVrkrRy0wmGaRC8ArZuwnxwD65Q4a94ftZvtsEY3YijJzmaT_NqmvYnWm787wS_NTdyZTiohdVsFb-4EKX7fYi5m7fOI82wDxm02XGkFGlrNKvr6H3QVtynU7QzXWnVSdFxXih-pMcWcE073n2FgDkmbY9KmJm1-JW26OvTq4Rr3I7-jrYA4Arm2wg2mP2__R_sTyey2dQ</recordid><startdate>20230201</startdate><enddate>20230201</enddate><creator>Jungwirth-Weinberger, Anna</creator><creator>Bendich, Ilya</creator><creator>Hanreich, Carola</creator><creator>Gonzalez Della Valle, Alejandro</creator><creator>Blevins, Jason L.</creator><creator>Westrich, Geoffrey H.</creator><creator>Boettner, Friedrich</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7906-9486</orcidid></search><sort><creationdate>20230201</creationdate><title>History of COVID-19 infection is not associated with increased d-dimer levels and risk of deep-vein thrombosis in total joint arthroplasty</title><author>Jungwirth-Weinberger, Anna ; Bendich, Ilya ; Hanreich, Carola ; Gonzalez Della Valle, Alejandro ; Blevins, Jason L. ; Westrich, Geoffrey H. ; Boettner, Friedrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-b996db15085a8759d7305dfa75301db6c06e264b75ebff3930eadfe9fd10ad53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Arthroplasty - adverse effects</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>Humans</topic><topic>Joint surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Thrombosis</topic><topic>Venous Thromboembolism - etiology</topic><topic>Venous Thrombosis - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jungwirth-Weinberger, Anna</creatorcontrib><creatorcontrib>Bendich, Ilya</creatorcontrib><creatorcontrib>Hanreich, Carola</creatorcontrib><creatorcontrib>Gonzalez Della Valle, Alejandro</creatorcontrib><creatorcontrib>Blevins, Jason L.</creatorcontrib><creatorcontrib>Westrich, Geoffrey H.</creatorcontrib><creatorcontrib>Boettner, Friedrich</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jungwirth-Weinberger, Anna</au><au>Bendich, Ilya</au><au>Hanreich, Carola</au><au>Gonzalez Della Valle, Alejandro</au><au>Blevins, Jason L.</au><au>Westrich, Geoffrey H.</au><au>Boettner, Friedrich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>History of COVID-19 infection is not associated with increased d-dimer levels and risk of deep-vein thrombosis in total joint arthroplasty</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2023-02-01</date><risdate>2023</risdate><volume>143</volume><issue>2</issue><spage>785</spage><epage>789</epage><pages>785-789</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
In the acute phase of COVID-19, elevated
d
-dimer levels indicate a hypercoagulable state putting the patients at increased risk for venous thromboembolic disease (VTE). It is unclear, if prior COVID-19 disease increases the risk for VTE after total joint arthroplasty (TJA) and if
d
-dimer levels can be used to identify patients at risk.
Materials and methods
d
-Dimer levels of 313 consecutive SARS-CoV-2 IgG-positive and 2,053 -negative patients undergoing TJA between 05/20 and 12/20 were evaluated.
d
-Dimer levels were divided into three groups: < 200 ng/ml, 200–400 ng/ml, and > 400 ng/ml
d
-dimer units (DDU). 277 SARS-CoV-2 IgG-positive patients underwent a Doppler ultrasound to rule out deep-vein thrombosis (DVT) 4–6 weeks after TJA.
Results
d
-Dimer levels did not differ significantly between SARS-CoV-2 IgG-positive and -negative patients (
p
value 0.53). Among SARS-CoV-2 IgG-negative patients, 1687 (82.17%) had
d
-dimer levels < 200 ng/ml, 256 (12.47%) between 200 and 400 ng/ml, and 110 (5.36%) > 400 ng/ml. Of the SARS-CoV-2 IgG-positive patients, 257 (83.71%) had
d
-dimer levels < 200 ng/ml, 34 (11.07%) between 200 and 400 ng/ml, and 16 (5.21%) > 400 ng/ml. A postoperative DVT was detected in nine patients (2.9%) in the SARS-CoV-2 IgG-positive group and a PE in one patient (0.3%). 7/229 patients with < 200 ng/ml (3.1%), 1/28 patients (3.6%) with 200–400 ng/ml and 1/9 patients (11.1%) with
d
-dimer levels > 400 ng/ml had a DVT or PE (
p
= 0.43).
Conclusions
The findings of this investigation suggest there is no difference in
d
-dimer levels between SARS-CoV-2 IgG-positive and -negative patients undergoing TJA. Although there is a trend for increased VTE rates with increased
d
-dimer levels, routine
d
-dimer testing is not recommended based on the current data. SARS-CoV-2 IgG-positive patients have a low risk of VTE in the current study.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34546422</pmid><doi>10.1007/s00402-021-04181-8</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-7906-9486</orcidid><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; SpringerLink Journals |
subjects | Arthroplasty - adverse effects Coronaviruses COVID-19 COVID-19 - complications Humans Joint surgery Medicine Medicine & Public Health Orthopaedic Surgery Orthopedics SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Thrombosis Venous Thromboembolism - etiology Venous Thrombosis - etiology |
title | History of COVID-19 infection is not associated with increased d-dimer levels and risk of deep-vein thrombosis in total joint arthroplasty |
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