COVID-19 and Pulmonary Thrombosis-An Unresolved Clinical Puzzle: A Single-Center Cohort Study
Pulmonary thrombosis (PT) is a frequent complication of COVID-19. However, the risk factors, predictive scores, and precise diagnostic guidelines on indications for CT pulmonary angiography (CTPA) are still lacking. This study aimed to analyze the clinical and laboratory characteristics associated w...
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| Veröffentlicht in: | Journal of clinical medicine 2022-11, Vol.11 (23), p.7049 |
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| creator | Močibob, Loris Šušak, Frano Šitum, Maja Višković, Klaudija Papić, Neven Vince, Adriana |
| description | Pulmonary thrombosis (PT) is a frequent complication of COVID-19. However, the risk factors, predictive scores, and precise diagnostic guidelines on indications for CT pulmonary angiography (CTPA) are still lacking. This study aimed to analyze the clinical and laboratory characteristics associated with PT in patients with COVID-19. We conducted a cohort study of consecutively hospitalized adult patients with COVID-19 who underwent CTPA at the University Hospital for Infectious Diseases in Zagreb, Croatia between 1 April and 31 December 2021. Of 2078 hospitalized patients, 575 (27.6%) underwent CTPA. PT was diagnosed in 178 (30.9%) patients (69.6% males, median age of 61, IQR 50-69 years). The PT group had a higher CRP, LDH, D-dimer, platelets, and CHOD score. PT was more frequent in patients requiring ≥15 L O
/min (25.0% vs. 39.7%). In multivariable analysis, only D-dimer ≥ 1.0 mg/L (OR 1.78, 95%CI 1.12-2.75) and O
≥ 15 L (OR 1.89, 95%CI 1.26-2.84) were associated with PT. PT was not associated with in-hospital mortality. In conclusion, our data confirmed a high incidence of PT in hospitalized patients with COVID-19, however, no correlation with traditional risk factors and mortality was found. CTPA should be performed in patients requiring high-flow supplemental oxygen or those with increased D-dimer levels. |
| doi_str_mv | 10.3390/jcm11237049 |
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/min (25.0% vs. 39.7%). In multivariable analysis, only D-dimer ≥ 1.0 mg/L (OR 1.78, 95%CI 1.12-2.75) and O
≥ 15 L (OR 1.89, 95%CI 1.26-2.84) were associated with PT. PT was not associated with in-hospital mortality. In conclusion, our data confirmed a high incidence of PT in hospitalized patients with COVID-19, however, no correlation with traditional risk factors and mortality was found. CTPA should be performed in patients requiring high-flow supplemental oxygen or those with increased D-dimer levels.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm11237049</identifier><identifier>PMID: 36498623</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Anticoagulants ; Blood platelets ; Clinical medicine ; Cohort analysis ; Coronaviruses ; COVID-19 ; Drug dosages ; Hospitalization ; Infectious diseases ; Laboratories ; Molecular weight ; Mortality ; Patients ; Pulmonary arteries ; Pulmonary embolisms ; Regression analysis ; Severe acute respiratory syndrome coronavirus 2 ; Software ; Thromboembolism ; Thrombosis ; Veins & arteries ; Ventilators</subject><ispartof>Journal of clinical medicine, 2022-11, Vol.11 (23), p.7049</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c339t-a2f83833f2297b505111b8b99b858fc4c54e58d25f9c123830e3eca7f61739a53</citedby><cites>FETCH-LOGICAL-c339t-a2f83833f2297b505111b8b99b858fc4c54e58d25f9c123830e3eca7f61739a53</cites><orcidid>0000-0002-5927-3201 ; 0000-0002-3866-2814 ; 0000-0001-5784-1343</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740696/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740696/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36498623$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Močibob, Loris</creatorcontrib><creatorcontrib>Šušak, Frano</creatorcontrib><creatorcontrib>Šitum, Maja</creatorcontrib><creatorcontrib>Višković, Klaudija</creatorcontrib><creatorcontrib>Papić, Neven</creatorcontrib><creatorcontrib>Vince, Adriana</creatorcontrib><title>COVID-19 and Pulmonary Thrombosis-An Unresolved Clinical Puzzle: A Single-Center Cohort Study</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Pulmonary thrombosis (PT) is a frequent complication of COVID-19. However, the risk factors, predictive scores, and precise diagnostic guidelines on indications for CT pulmonary angiography (CTPA) are still lacking. This study aimed to analyze the clinical and laboratory characteristics associated with PT in patients with COVID-19. We conducted a cohort study of consecutively hospitalized adult patients with COVID-19 who underwent CTPA at the University Hospital for Infectious Diseases in Zagreb, Croatia between 1 April and 31 December 2021. Of 2078 hospitalized patients, 575 (27.6%) underwent CTPA. PT was diagnosed in 178 (30.9%) patients (69.6% males, median age of 61, IQR 50-69 years). The PT group had a higher CRP, LDH, D-dimer, platelets, and CHOD score. PT was more frequent in patients requiring ≥15 L O
/min (25.0% vs. 39.7%). In multivariable analysis, only D-dimer ≥ 1.0 mg/L (OR 1.78, 95%CI 1.12-2.75) and O
≥ 15 L (OR 1.89, 95%CI 1.26-2.84) were associated with PT. PT was not associated with in-hospital mortality. In conclusion, our data confirmed a high incidence of PT in hospitalized patients with COVID-19, however, no correlation with traditional risk factors and mortality was found. CTPA should be performed in patients requiring high-flow supplemental oxygen or those with increased D-dimer levels.</description><subject>Anticoagulants</subject><subject>Blood platelets</subject><subject>Clinical medicine</subject><subject>Cohort analysis</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Drug dosages</subject><subject>Hospitalization</subject><subject>Infectious diseases</subject><subject>Laboratories</subject><subject>Molecular weight</subject><subject>Mortality</subject><subject>Patients</subject><subject>Pulmonary arteries</subject><subject>Pulmonary embolisms</subject><subject>Regression analysis</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Software</subject><subject>Thromboembolism</subject><subject>Thrombosis</subject><subject>Veins & arteries</subject><subject>Ventilators</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkU1r2zAAhsVYWUua0-5DsMuguNWHZUk7DIK3fkChhSa7DSHLcuMgS61kB9pfX412IasuEujh5Xl5AfiM0SmlEp1tzIAxoRyV8gM4IojzAlFBP-69D8E8pQ3KR4iSYP4JHNKqlKIi9Aj8qW9-X_0ssITat_B2ckPwOj7B5TqGoQmpT8XCw5WPNgW3tS2sXe97o11mn5-d_Q4X8K73984WtfWjjbAO6xBHeDdO7dMxOOi0S3b-ds_A6vzXsr4srm8ururFdWFyibHQpBNZlHaESN4wxDDGjWikbAQTnSkNKy0TLWGdNLmsoMhSazTvKsyp1IzOwI_X3IepGWxrsknUTj3EfshlVNC9-v_H92t1H7ZK8hJVssoB394CYnicbBrV0CdjndPehikpwhmlSHDCM_r1HboJU_S5XqZKwahk2XEGTl4pE0NK0XY7GYzU3-XU3nKZ_rLvv2P_7URfAIaJkk0</recordid><startdate>20221129</startdate><enddate>20221129</enddate><creator>Močibob, Loris</creator><creator>Šušak, Frano</creator><creator>Šitum, Maja</creator><creator>Višković, Klaudija</creator><creator>Papić, Neven</creator><creator>Vince, Adriana</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5927-3201</orcidid><orcidid>https://orcid.org/0000-0002-3866-2814</orcidid><orcidid>https://orcid.org/0000-0001-5784-1343</orcidid></search><sort><creationdate>20221129</creationdate><title>COVID-19 and Pulmonary Thrombosis-An Unresolved Clinical Puzzle: A Single-Center Cohort Study</title><author>Močibob, Loris ; Šušak, Frano ; Šitum, Maja ; Višković, Klaudija ; Papić, Neven ; Vince, Adriana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c339t-a2f83833f2297b505111b8b99b858fc4c54e58d25f9c123830e3eca7f61739a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anticoagulants</topic><topic>Blood platelets</topic><topic>Clinical medicine</topic><topic>Cohort analysis</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Drug dosages</topic><topic>Hospitalization</topic><topic>Infectious diseases</topic><topic>Laboratories</topic><topic>Molecular weight</topic><topic>Mortality</topic><topic>Patients</topic><topic>Pulmonary arteries</topic><topic>Pulmonary embolisms</topic><topic>Regression analysis</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Software</topic><topic>Thromboembolism</topic><topic>Thrombosis</topic><topic>Veins & arteries</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Močibob, Loris</creatorcontrib><creatorcontrib>Šušak, Frano</creatorcontrib><creatorcontrib>Šitum, Maja</creatorcontrib><creatorcontrib>Višković, Klaudija</creatorcontrib><creatorcontrib>Papić, Neven</creatorcontrib><creatorcontrib>Vince, Adriana</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</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 Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Močibob, Loris</au><au>Šušak, Frano</au><au>Šitum, Maja</au><au>Višković, Klaudija</au><au>Papić, Neven</au><au>Vince, Adriana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>COVID-19 and Pulmonary Thrombosis-An Unresolved Clinical Puzzle: A Single-Center Cohort Study</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2022-11-29</date><risdate>2022</risdate><volume>11</volume><issue>23</issue><spage>7049</spage><pages>7049-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Pulmonary thrombosis (PT) is a frequent complication of COVID-19. However, the risk factors, predictive scores, and precise diagnostic guidelines on indications for CT pulmonary angiography (CTPA) are still lacking. This study aimed to analyze the clinical and laboratory characteristics associated with PT in patients with COVID-19. We conducted a cohort study of consecutively hospitalized adult patients with COVID-19 who underwent CTPA at the University Hospital for Infectious Diseases in Zagreb, Croatia between 1 April and 31 December 2021. Of 2078 hospitalized patients, 575 (27.6%) underwent CTPA. PT was diagnosed in 178 (30.9%) patients (69.6% males, median age of 61, IQR 50-69 years). The PT group had a higher CRP, LDH, D-dimer, platelets, and CHOD score. PT was more frequent in patients requiring ≥15 L O
/min (25.0% vs. 39.7%). In multivariable analysis, only D-dimer ≥ 1.0 mg/L (OR 1.78, 95%CI 1.12-2.75) and O
≥ 15 L (OR 1.89, 95%CI 1.26-2.84) were associated with PT. PT was not associated with in-hospital mortality. In conclusion, our data confirmed a high incidence of PT in hospitalized patients with COVID-19, however, no correlation with traditional risk factors and mortality was found. CTPA should be performed in patients requiring high-flow supplemental oxygen or those with increased D-dimer levels.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36498623</pmid><doi>10.3390/jcm11237049</doi><orcidid>https://orcid.org/0000-0002-5927-3201</orcidid><orcidid>https://orcid.org/0000-0002-3866-2814</orcidid><orcidid>https://orcid.org/0000-0001-5784-1343</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anticoagulants Blood platelets Clinical medicine Cohort analysis Coronaviruses COVID-19 Drug dosages Hospitalization Infectious diseases Laboratories Molecular weight Mortality Patients Pulmonary arteries Pulmonary embolisms Regression analysis Severe acute respiratory syndrome coronavirus 2 Software Thromboembolism Thrombosis Veins & arteries Ventilators |
| title | COVID-19 and Pulmonary Thrombosis-An Unresolved Clinical Puzzle: A Single-Center Cohort Study |
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