Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.

Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy

Melazzini, Federica;Colaneri, Marta;Fumoso, Federica;Freddi, Giulia;Lenti, Marco Vincenzo;Pieri, Teresa Chiara;Piloni, Davide;Noris, Patrizia;Preti, Paola Stefania;Russo, Mariaconcetta;Corsico, Angelo;Tavazzi, Guido;Baldanti, Fausto;Mojoli, Francesco;Bruno, Raffaele;Di Sabatino, Antonio;Aronico Nicola;Bergamaschi Gaetano;Costanzo Filippo;Derosa Giuseppe;Di Stefano Michele;Falaschi Francesco;Iadarola Carmine;Lovati Elisabetta;Martignoni Alessandra;Mengoli Caterina;Miceli Emanuela;Mugellini Amedeo;Pagani Elisabetta;Palumbo Ilaria;Pecci Alessandro;Perrone Tiziano;Sgarlata Carmelo;Staniscia Andrea;Achilli Giovanna;Agostinelli Andrea;Antoci Valentina;Ballesio Alessia;Banfi Francesco;Barteselli Chiara;Benedetti Irene;Borrelli de Andreis Federica;Brattoli Michele;Calabretta Francesca;Cambiè Ginevra;Canta Roberta;Conca Federico;Coppola Luigi;Cremonte Elisa Maria;Croce Gabriele;Del Rio Virginia;Di Terlizzi Francesco;Ferrari Maria Giovanna;Ferrari Sara;Fiengo Anna;Forni Tommaso;Frigerio Chiara;Fusco Alessandra;Gabba Margherita;Garolfi Matteo;Gentile Antonella;Gori Giulia;Grandi Giacomo;Grimaldi Paolo;Lampugnani Alice;Lapia Francesco;Lepore Federica;Lettieri Gianluca;Mambella Jacopo;Mercanti Chiara;Merli Stefania;Mordà Francesco;Nardone Alba;Pace Luca;Padovini Lucia;Parodi Alessandro;Pellegrino Ivan;Pitotti Lavinia;Reduzzi Margherita;Rigano Giovanni;Romito Giovanni;Rotola Giorgio;Sabatini Umberto;Salvi Lucia;Santacroce Giovanni;Savioli Jessica;Soriano Simone;Spataro Carmine;Amatu Alessandro;Arisi Eric;Baldi Chiara;Belliato Mirko;Bellini Lorenzo;Benzi Alberto;Bolongaro Antonia;Bottazzi Andrea;Broglia Federica;Bruschi Giacomo;Caneva Luca;Capaccio Emanuele;Carboni Valeria;Ciceri Maria;Civardi Luca;Ferrari Fiorenza;Ferrari Marta;Fuardo Marinella;Lo Coco Claudia;Maggio Giuseppe;Mascia Maria Benedetta;Mencherini Simonetta;Mongodi Silvia;Morgante Federica;Niebel Thekla Larissa;Orlando Anita;Passador Debora;Pellicori Simona;Perotti Luciano;Picchioni Raffaella;Poma Silvia;Puce Roberta;Radolovich Danila Katia;Ragni Gianluca;Repossi Filippo;Riccardi Francesca;Roldi Emanuela;Romito Giovanni;Rossi Cristina;Sciutti Fabio;Sportiello Debora;Bagliani Alessandro;Belotti Corrado;Bossi Chiara;Colombo Costanza Natalia Julia;Cremascoli Luca;Dammassa Valentino;Discepoli Roberto;Garlando Maria Adelaide;Grandini Filippo;Pellegrini Andrea;Quaranta Cecilia;Stella Andrea;Brunetti Enrico;Seminari Elena;Maiocchi Laura;Zuccaro Valentina;Pagnucco Layla;Mariani Bianca;Ludovisi Serena;Lissandrin Raffaella;Sacchi Paolo;Maserati Renato;Orsolini Paolo;Vecchia Marco;Asperges Erika;Di Filippo Alessandro;Sambo Margherita;Biscarini Simona;Lupi Matteo;Roda Silvia;Gallazzi Ilaria;Sachs Michele;Valsecchi Pietro;Mariani Bianca;Bosio Matteo;Conio Valentina;Di Domenica Rita;Fraolini Elia;Meloni Federica;Ronzoni Vanessa;Saracino Laura;Stella Giulia;Abbate Tommaso;Accordino Giulia;Bertuccio Francesco;Burattini Cecilia;Cacciatore Elisa;Cattaneo Elena;Chino Vittorio;Coretti Manuela;Della Zoppa Matteo;Infusino Cristina;Lettieri Sara;Maccabruni Valeria;Mancinelli Silvia;Tirelli Claudio;Vertui Valentina
2021-01-01

Abstract

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11571/1486075
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