Mortality and bleeding complications of CoVID-19 critically ill patients with venous thromboembolism
Gil-Sala, Daniel (Hospital Universitari Vall d'Hebron)
Riera, Clàudia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
García Reyes, Marvin Ernesto (Hospital Universitari Vall d'Hebron)
Rodríguez, Manuela (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Marrero, Carlos (Hospital Universitari Vall d'Hebron)
Martínez, Lucia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Gil Olaria, Miquel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ruiz-Rodriguez, Juan Carlos (Hospital Universitari Vall d'Hebron)
Ferrer, Ricard (Hospital Universitari Vall d'Hebron)
Nadal Clanchet, Miriam de (Hospital Universitari Vall d'Hebron)
Suito Alcántara, Milagros A. (Hospital Universitari Vall d'Hebron)
Llagostera Pujol, Secundino (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bellmunt Montoya, Sergi (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Data:	2022
Resum:	Background: Venous thromboembolism (VTE) disease in COVID-19 patients is a remarkable issue, especially its relationship with bleeding events and mortality. The objective of this study was to describe the outcomes of critically ill patients with COVID-19, hospitalized in the Intensive Care Unit (ICU), in relationship with VTE during their stay. Methods: This is a prospective cohort study of critically ill COVID-19 patients in two hospitals that underwent a venous ultrasound at the beginning of follow-up of both lower limbs in April 2020. In case of clinical suspicion of new VTE during the 30-day follow-up, additional ultrasound or thoracic CT were performed. Global VTE frequency, major bleeding events and survival were collected, and their predictors were studied. Results: We included 230 patients. After 30 days of follow-up, there were 95 VTE events in 86 patients (37. 4%). Thirteen patients (5. 7%) developed major bleeding complications and 42 patients (18. 3%) died. None of the comorbidities or previous treatments were related with bleeding events. D-Dimer at admission was significantly related with VTE development and mortality. Independent predictors of mortality in the regression model were older age (>66 years), D-Dimer at admission (>1. 500 ng/mL) and low lymphocyte count (<0. 45×10/L) with an AUC in the ROC curve of 0. 81 (95% CI: 0. 73-0. 89). Patients presenting these three conditions presented a mortality of 100% in the predictive model. Conclusions: VTE frequency in ICU COVID-19 patients is high and risk of major bleeding is low. Comorbidities and laboratory parameters of admission in these patients can be a useful tool to predict mortality.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	SARS-CoV-2 infection ; COVID19 ; Venous thromboembolism ; Deep venous thrombosis ; Mortality ; Bleeding
Publicat a:	International Angiology, Vol. 41, Num. 1 (February 2022) , p. 1-8, ISSN 1827-1839

DOI: 10.23736/S0392-9590.21.04704-0

21 p, 332.1 KB

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