Screening Protocol and Prevalence of Venous Thromboembolic Disease in Hospitalized Patients With COVID‐19
Background SARS‐CoV‐2 disease (COVID‐19) induces endothelial damage and sustained hypoxia and facilitates immobilization as factors of hypercoagulability. Objectives The objective of our study was to assess the prevalence of venous thromboembolic disease (VTD) in COVID‐19 patients and the usefulness...
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| Veröffentlicht in: | Journal of ultrasound in medicine 2022-07, Vol.41 (7), p.1689-1698 |
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| creator | Álvarez‐Troncoso, Jorge Ramos‐Ruperto, Luis Fernández‐Cidón, Pelayo Trigo‐Esteban, Elena Tung‐Chen, Yale Busca‐Arenzana, Carmen Quintana‐Díaz, Manuel Buño‐Soto, Antonio Arnalich‐Fernández, Francisco Fernández‐Capitán, Carmen |
| description | Background
SARS‐CoV‐2 disease (COVID‐19) induces endothelial damage and sustained hypoxia and facilitates immobilization as factors of hypercoagulability.
Objectives
The objective of our study was to assess the prevalence of venous thromboembolic disease (VTD) in COVID‐19 patients and the usefulness of VTD screening based on age‐adjusted D‐dimer and point‐of‐care ultrasound (POCUS).
Patients/Methods
We conducted a single cohort, prospective observational study in 102 consecutive hospitalized patients.
Results
A total of 102 POCUS and 39 pulmonary computed tomography angiography (PCTA) were performed diagnosing 27 VTD (26.5%): 17 deep vein thrombosis (DVT) (16.6% positive POCUS) and 18 pulmonary embolism (PE) (46.2% positive PCTA). COVID‐19 patients with VTD were older (P |
| doi_str_mv | 10.1002/jum.15850 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8661624</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2585925157</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4430-b058cb817a8df9cccd90a8420ba0d66b999208ee775e26e5a8f4a297091c1ae23</originalsourceid><addsrcrecordid>eNp1kc9uFSEUh0mjsdfqwhcwLO1iWmBgBjZNmttqa2pq0n9LwjBneqkM3MLcmrryEXxGn0T01kYXXRBC-PjO4fwQekPJDiWE7d6sxh0qpCAbaEaFIJVqaP0MzQhrZcWZajfRy5xvCkpoy1-gzZo3ipOazdCXM5sAggvX-HOKU7TRYxP6coA74yFYwHHAlxDiKuPzRYpjF6Es7yw-cBlMBuwCPop56Sbj3Tcob83kIEwZX7lpgeenl8cHP7__oOoVej4Yn-H1w76FLt4fns-PqpPTD8fz_ZPKcl6TqiNC2k7S1sh-UNbaXhEjOSOdIX3TdEopRiRA2wpgDQgjB27KJ4milhpg9RbaW3uXq26E3pZekvF6mdxo0r2Oxun_b4Jb6Ot4p2XT0IbxInj3IEjxdgV50qPLFrw3AcocNCuzVkxQ0RZ0e43aFHNOMDyWoUT_DkeXcPSfcAr79t--Hsm_aRRgdw18dR7unzbpjxef1spfW2ubpg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2585925157</pqid></control><display><type>article</type><title>Screening Protocol and Prevalence of Venous Thromboembolic Disease in Hospitalized Patients With COVID‐19</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Álvarez‐Troncoso, Jorge ; Ramos‐Ruperto, Luis ; Fernández‐Cidón, Pelayo ; Trigo‐Esteban, Elena ; Tung‐Chen, Yale ; Busca‐Arenzana, Carmen ; Quintana‐Díaz, Manuel ; Buño‐Soto, Antonio ; Arnalich‐Fernández, Francisco ; Fernández‐Capitán, Carmen</creator><creatorcontrib>Álvarez‐Troncoso, Jorge ; Ramos‐Ruperto, Luis ; Fernández‐Cidón, Pelayo ; Trigo‐Esteban, Elena ; Tung‐Chen, Yale ; Busca‐Arenzana, Carmen ; Quintana‐Díaz, Manuel ; Buño‐Soto, Antonio ; Arnalich‐Fernández, Francisco ; Fernández‐Capitán, Carmen</creatorcontrib><description>Background
SARS‐CoV‐2 disease (COVID‐19) induces endothelial damage and sustained hypoxia and facilitates immobilization as factors of hypercoagulability.
Objectives
The objective of our study was to assess the prevalence of venous thromboembolic disease (VTD) in COVID‐19 patients and the usefulness of VTD screening based on age‐adjusted D‐dimer and point‐of‐care ultrasound (POCUS).
Patients/Methods
We conducted a single cohort, prospective observational study in 102 consecutive hospitalized patients.
Results
A total of 102 POCUS and 39 pulmonary computed tomography angiography (PCTA) were performed diagnosing 27 VTD (26.5%): 17 deep vein thrombosis (DVT) (16.6% positive POCUS) and 18 pulmonary embolism (PE) (46.2% positive PCTA). COVID‐19 patients with VTD were older (P < .030), had higher D‐dimer (P < .001), higher International Society on Thrombosis and Hemostasis score (P < .001), and higher mortality (P = .025). However, there were no differences in inflammatory laboratory parameters neither in the cytokine storm syndrome (CSS) development. The ROC curve for D‐dimer showed an AUC of 0.91. We have evidenced that patients with D‐dimer between 2000 and 6000 ng/mL could benefit from a screening strategy with POCUS given the high sensitivity and specificity of the test. Furthermore, patients with D‐dimer ≥6000 ng/mL should undergo POCUS and PCTA to rule out DVT and PE, respectively.
Conclusions
In our cohort, 26.5% of the patients presented VTD. Screening strategy based on age‐adjusted D‐dimer and POCUS proved high sensitivity and specificity. Future trials focused on screening strategies are necessary to early detect the presence of DVT and PE and determine thromboprophylaxis strategies in patients with COVID‐19.</description><identifier>ISSN: 0278-4297</identifier><identifier>EISSN: 1550-9613</identifier><identifier>DOI: 10.1002/jum.15850</identifier><identifier>PMID: 34694032</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>COVID‐19 ; Original ; SARS‐CoV2 ; thrombosis ; ultrasound</subject><ispartof>Journal of ultrasound in medicine, 2022-07, Vol.41 (7), p.1689-1698</ispartof><rights>2021 American Institute of Ultrasound in Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4430-b058cb817a8df9cccd90a8420ba0d66b999208ee775e26e5a8f4a297091c1ae23</citedby><cites>FETCH-LOGICAL-c4430-b058cb817a8df9cccd90a8420ba0d66b999208ee775e26e5a8f4a297091c1ae23</cites><orcidid>0000-0002-5613-3609 ; 0000-0003-1108-9461</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjum.15850$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjum.15850$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34694032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Álvarez‐Troncoso, Jorge</creatorcontrib><creatorcontrib>Ramos‐Ruperto, Luis</creatorcontrib><creatorcontrib>Fernández‐Cidón, Pelayo</creatorcontrib><creatorcontrib>Trigo‐Esteban, Elena</creatorcontrib><creatorcontrib>Tung‐Chen, Yale</creatorcontrib><creatorcontrib>Busca‐Arenzana, Carmen</creatorcontrib><creatorcontrib>Quintana‐Díaz, Manuel</creatorcontrib><creatorcontrib>Buño‐Soto, Antonio</creatorcontrib><creatorcontrib>Arnalich‐Fernández, Francisco</creatorcontrib><creatorcontrib>Fernández‐Capitán, Carmen</creatorcontrib><title>Screening Protocol and Prevalence of Venous Thromboembolic Disease in Hospitalized Patients With COVID‐19</title><title>Journal of ultrasound in medicine</title><addtitle>J Ultrasound Med</addtitle><description>Background
SARS‐CoV‐2 disease (COVID‐19) induces endothelial damage and sustained hypoxia and facilitates immobilization as factors of hypercoagulability.
Objectives
The objective of our study was to assess the prevalence of venous thromboembolic disease (VTD) in COVID‐19 patients and the usefulness of VTD screening based on age‐adjusted D‐dimer and point‐of‐care ultrasound (POCUS).
Patients/Methods
We conducted a single cohort, prospective observational study in 102 consecutive hospitalized patients.
Results
A total of 102 POCUS and 39 pulmonary computed tomography angiography (PCTA) were performed diagnosing 27 VTD (26.5%): 17 deep vein thrombosis (DVT) (16.6% positive POCUS) and 18 pulmonary embolism (PE) (46.2% positive PCTA). COVID‐19 patients with VTD were older (P < .030), had higher D‐dimer (P < .001), higher International Society on Thrombosis and Hemostasis score (P < .001), and higher mortality (P = .025). However, there were no differences in inflammatory laboratory parameters neither in the cytokine storm syndrome (CSS) development. The ROC curve for D‐dimer showed an AUC of 0.91. We have evidenced that patients with D‐dimer between 2000 and 6000 ng/mL could benefit from a screening strategy with POCUS given the high sensitivity and specificity of the test. Furthermore, patients with D‐dimer ≥6000 ng/mL should undergo POCUS and PCTA to rule out DVT and PE, respectively.
Conclusions
In our cohort, 26.5% of the patients presented VTD. Screening strategy based on age‐adjusted D‐dimer and POCUS proved high sensitivity and specificity. Future trials focused on screening strategies are necessary to early detect the presence of DVT and PE and determine thromboprophylaxis strategies in patients with COVID‐19.</description><subject>COVID‐19</subject><subject>Original</subject><subject>SARS‐CoV2</subject><subject>thrombosis</subject><subject>ultrasound</subject><issn>0278-4297</issn><issn>1550-9613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kc9uFSEUh0mjsdfqwhcwLO1iWmBgBjZNmttqa2pq0n9LwjBneqkM3MLcmrryEXxGn0T01kYXXRBC-PjO4fwQekPJDiWE7d6sxh0qpCAbaEaFIJVqaP0MzQhrZcWZajfRy5xvCkpoy1-gzZo3ipOazdCXM5sAggvX-HOKU7TRYxP6coA74yFYwHHAlxDiKuPzRYpjF6Es7yw-cBlMBuwCPop56Sbj3Tcob83kIEwZX7lpgeenl8cHP7__oOoVej4Yn-H1w76FLt4fns-PqpPTD8fz_ZPKcl6TqiNC2k7S1sh-UNbaXhEjOSOdIX3TdEopRiRA2wpgDQgjB27KJ4milhpg9RbaW3uXq26E3pZekvF6mdxo0r2Oxun_b4Jb6Ot4p2XT0IbxInj3IEjxdgV50qPLFrw3AcocNCuzVkxQ0RZ0e43aFHNOMDyWoUT_DkeXcPSfcAr79t--Hsm_aRRgdw18dR7unzbpjxef1spfW2ubpg</recordid><startdate>202207</startdate><enddate>202207</enddate><creator>Álvarez‐Troncoso, Jorge</creator><creator>Ramos‐Ruperto, Luis</creator><creator>Fernández‐Cidón, Pelayo</creator><creator>Trigo‐Esteban, Elena</creator><creator>Tung‐Chen, Yale</creator><creator>Busca‐Arenzana, Carmen</creator><creator>Quintana‐Díaz, Manuel</creator><creator>Buño‐Soto, Antonio</creator><creator>Arnalich‐Fernández, Francisco</creator><creator>Fernández‐Capitán, Carmen</creator><general>John Wiley & Sons, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5613-3609</orcidid><orcidid>https://orcid.org/0000-0003-1108-9461</orcidid></search><sort><creationdate>202207</creationdate><title>Screening Protocol and Prevalence of Venous Thromboembolic Disease in Hospitalized Patients With COVID‐19</title><author>Álvarez‐Troncoso, Jorge ; Ramos‐Ruperto, Luis ; Fernández‐Cidón, Pelayo ; Trigo‐Esteban, Elena ; Tung‐Chen, Yale ; Busca‐Arenzana, Carmen ; Quintana‐Díaz, Manuel ; Buño‐Soto, Antonio ; Arnalich‐Fernández, Francisco ; Fernández‐Capitán, Carmen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4430-b058cb817a8df9cccd90a8420ba0d66b999208ee775e26e5a8f4a297091c1ae23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>COVID‐19</topic><topic>Original</topic><topic>SARS‐CoV2</topic><topic>thrombosis</topic><topic>ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Álvarez‐Troncoso, Jorge</creatorcontrib><creatorcontrib>Ramos‐Ruperto, Luis</creatorcontrib><creatorcontrib>Fernández‐Cidón, Pelayo</creatorcontrib><creatorcontrib>Trigo‐Esteban, Elena</creatorcontrib><creatorcontrib>Tung‐Chen, Yale</creatorcontrib><creatorcontrib>Busca‐Arenzana, Carmen</creatorcontrib><creatorcontrib>Quintana‐Díaz, Manuel</creatorcontrib><creatorcontrib>Buño‐Soto, Antonio</creatorcontrib><creatorcontrib>Arnalich‐Fernández, Francisco</creatorcontrib><creatorcontrib>Fernández‐Capitán, Carmen</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of ultrasound in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Álvarez‐Troncoso, Jorge</au><au>Ramos‐Ruperto, Luis</au><au>Fernández‐Cidón, Pelayo</au><au>Trigo‐Esteban, Elena</au><au>Tung‐Chen, Yale</au><au>Busca‐Arenzana, Carmen</au><au>Quintana‐Díaz, Manuel</au><au>Buño‐Soto, Antonio</au><au>Arnalich‐Fernández, Francisco</au><au>Fernández‐Capitán, Carmen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Screening Protocol and Prevalence of Venous Thromboembolic Disease in Hospitalized Patients With COVID‐19</atitle><jtitle>Journal of ultrasound in medicine</jtitle><addtitle>J Ultrasound Med</addtitle><date>2022-07</date><risdate>2022</risdate><volume>41</volume><issue>7</issue><spage>1689</spage><epage>1698</epage><pages>1689-1698</pages><issn>0278-4297</issn><eissn>1550-9613</eissn><abstract>Background
SARS‐CoV‐2 disease (COVID‐19) induces endothelial damage and sustained hypoxia and facilitates immobilization as factors of hypercoagulability.
Objectives
The objective of our study was to assess the prevalence of venous thromboembolic disease (VTD) in COVID‐19 patients and the usefulness of VTD screening based on age‐adjusted D‐dimer and point‐of‐care ultrasound (POCUS).
Patients/Methods
We conducted a single cohort, prospective observational study in 102 consecutive hospitalized patients.
Results
A total of 102 POCUS and 39 pulmonary computed tomography angiography (PCTA) were performed diagnosing 27 VTD (26.5%): 17 deep vein thrombosis (DVT) (16.6% positive POCUS) and 18 pulmonary embolism (PE) (46.2% positive PCTA). COVID‐19 patients with VTD were older (P < .030), had higher D‐dimer (P < .001), higher International Society on Thrombosis and Hemostasis score (P < .001), and higher mortality (P = .025). However, there were no differences in inflammatory laboratory parameters neither in the cytokine storm syndrome (CSS) development. The ROC curve for D‐dimer showed an AUC of 0.91. We have evidenced that patients with D‐dimer between 2000 and 6000 ng/mL could benefit from a screening strategy with POCUS given the high sensitivity and specificity of the test. Furthermore, patients with D‐dimer ≥6000 ng/mL should undergo POCUS and PCTA to rule out DVT and PE, respectively.
Conclusions
In our cohort, 26.5% of the patients presented VTD. Screening strategy based on age‐adjusted D‐dimer and POCUS proved high sensitivity and specificity. Future trials focused on screening strategies are necessary to early detect the presence of DVT and PE and determine thromboprophylaxis strategies in patients with COVID‐19.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>34694032</pmid><doi>10.1002/jum.15850</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-5613-3609</orcidid><orcidid>https://orcid.org/0000-0003-1108-9461</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | COVID‐19 Original SARS‐CoV2 thrombosis ultrasound |
| title | Screening Protocol and Prevalence of Venous Thromboembolic Disease in Hospitalized Patients With COVID‐19 |
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