Pulmonary thromboembolism in coronavirus disease 2019 patients undergoing thromboprophylaxis

Dataset from Schiaffino S, Giacomazzi F, Esseridou A, Cozzi A, Carriero S, Mazzaccaro DP, Nano G, Di Leo G, Spagnolo P, Sardanelli F. Pulmonary thromboembolism in coronavirus disease 2019 patients undergoing thromboprophylaxis. Medicine (Baltimore). 2021 Jan 8;100(1):e24002. doi: 10.1097/MD.0000000000024002. PMID: 33429763; PMCID: PMC7793450.

Abstract

We aimed to investigate the prevalence of pulmonary thromboembolism (PTE) and its association with clinical variables in a cohort of hospitalized coronavirus disease 2019 (COVID-19) patients receiving low-molecular-weight heparin (LMWH) at prophylactic dosage.In this retrospective observational study we included COVID-19 patients receiving prophylactic LMWH from admission but still referred for lower-limbs venous Doppler ultrasound (LL-US) and computed tomography pulmonary angiography (CTPA) for clinical PTE suspicion. A dedicated radiologist reviewed CTPA images to assess PTE presence/extension.From March 1 to April 30, 2020, 45 patients were included (34 men, median age 67 years, interquartile range [IQR] 60-76). Twenty-seven (60%) had PTE signs at CTPA, 17/27 (63%) with bilateral involvement, none with main branch PTE. In 33/45 patients (73%) patients LL-US was performed before CTPA, with 3 patients having superficial vein thrombosis (9%, none with CTPA-confirmed PTE) and 1 patient having deep vein thrombosis (3%, with CTPA-confirmed PTE). Thirty-three patients (73%) had at least one comorbidity, mainly hypertension (23/45, 51%) and cardiovascular disease (15/45, 33%). Before CTPA, 5 patients had high D-dimer (11.21 μg/mL, IQR 9.10-13.02), 19 high fibrinogen (550 mg/dL, IQR 476-590), 26 high interleukin-6 (79 pg/mL, IQR 31-282), and 11 high C-reactive protein (9.60 mg/dL, IQR 6.75-10.65), C-reactive protein being the only laboratory parameter significantly differing between patients with and without PTE (P = .002)High PTE incidence (60%) in COVID-19 hospitalized patients under prophylactic LMWH could substantiate further tailoring of anticoagulation therapy.