Biomarkers for the prediction of venous thromboembolism in critically ill COVID-19 patients
| العنوان: | Biomarkers for the prediction of venous thromboembolism in critically ill COVID-19 patients |
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| المؤلفون: | Marcella C.A. Müller, Alexander P.J. Vlaar, Romein W. G. Dujardin, Jecko Thachil, Saskia Middeldorp, Wolmet E. Haksteen, Bashar N. Hilderink, Nicole P. Juffermans |
| المساهمون: | Vascular Medicine, ACS - Pulmonary hypertension & thrombosis, ARD - Amsterdam Reproduction and Development, Intensive Care Medicine, ACS - Microcirculation |
| المصدر: | Thrombosis Research Thrombosis research, 196, 308-312. Elsevier Limited |
| بيانات النشر: | Elsevier BV, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Multivariate analysis, VTE, venous thromboembolism, 030204 cardiovascular system & hematology, Hypoxemia, law.invention, AUC, area under the curve, 0302 clinical medicine, PCR, polymerase chain reaction, CRP, c-reactive protein, Risk Factors, law, PPV, positive predicting value, COVID-19, coronavirus disease 2019, medicine.diagnostic_test, Area under the curve, INR, international normalized ratio, ROC, receiver operating characteristics, Hematology, Middle Aged, Intensive care unit, ICU, intensive care unit, CT, computed tomography, 030220 oncology & carcinogenesis, DVT, deep venous thrombosis, Female, medicine.symptom, Partial thromboplastin time, Venous thromboembolism, medicine.medical_specialty, Kg, kilogram, aPTT, activated partial thromboplastin time, C-reactive protein, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, Internal medicine, Full Length Article, PT, prothrombin time, medicine, NPV, negative predicting value, Humans, cardiovascular diseases, LMWH, low-molecular-weight heparin, ARDS, acute respiratory distress syndrome, Aged, Retrospective Studies, Receiver operating characteristic, SARS-CoV-2, business.industry, COVID-19, Retrospective cohort study, SARS-CoV-2, severe Acute Respiratory Syndrome Coronavirus-2, PEEP, positive end expiratory pressure, D-dimer, PE, pulmonary embolism, business, Complication, Critical illness, Biomarkers |
| الوصف: | Background Venous thromboembolism (VTE) is a frequent complication in critically ill patients with coronavirus disease 2019 (COVID-19) and is associated with mortality. Early diagnosis and treatment of VTE is warranted. Objective To develop a prediction model for VTE in critically ill COVID-19 patients. Patients and methods In this retrospective cohort study, 127 adult patients with confirmed COVID-19 infection admitted to the intensive care unit of two teaching hospitals were included. VTE was diagnosed with either ultrasound or computed tomography scan. Univariate receiver operating characteristic (ROC) curves were constructed for Positive End Expiratory Pressure, PaO2/FiO2 ratio, platelet count, international normalized ratio, activated partial thromboplastin time as well as levels of fibrinogen, antithrombin, D-dimer and C-reactive protein (CRP). Multivariate analysis was done using binary linear regression. Results Variables associated with VTE in both univariate and multivariate analysis were D-dimer and CRP with an area under the curve (AUC) of 0.64, P = 0.023 and 0.75, P = 0.045, respectively. Variables indicating hypoxemia were not predictive. The ROC curve of D-dimer and CRP combined had an AUC of 0.83, P 15 in combination with a CRP > 280 was 98%. The negative predictive value of D-dimer was low. Conclusion Elevated CRP and D-dimer have a high positive predictive value for VTE in critically ill COVID-19 patients. We developed a prediction table with these biomarkers that can aid clinicians in the timing of imaging in patients with suspected VTE. Highlights • Venous thromboembolisms are a frequently observed complication of COVID-19. • Markers of oxygenation are not predictive of venous thromboembolism. • Elevated C-reactive protein and D-dimer have the potential to predict venous thromboembolism. • We created a prediction tool based on elevations in both CRP and D-dimer to optimize time of imaging. |
| اللغة: | English |
| تدمد: | 0049-3848 |
| DOI: | 10.1016/j.thromres.2020.09.017 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::92eeadb0e6bb0dcb443ceb577d3d653f |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....92eeadb0e6bb0dcb443ceb577d3d653f |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 00493848 |
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| DOI: | 10.1016/j.thromres.2020.09.017 |