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Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy

Lodigiani, Corrado ; Iapichino, Giacomo ; Carenzo, Luca ; Cecconi, Maurizio ; Ferrazzi, Paola ; Sebastian, Tim ; Kucher, Nils ; Studt, Jan-Dirk ; Sacco, Clara ; Bertuzzi, Alexia ; Sandri, Maria Teresa ; Barco, Stefano

Thrombosis research, 2020-07, Vol.191, p.9-14 [Periódico revisado por pares]

United States: Elsevier Ltd

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Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy
Autor: Lodigiani, Corrado ; Iapichino, Giacomo ; Carenzo, Luca ; Cecconi, Maurizio ; Ferrazzi, Paola ; Sebastian, Tim ; Kucher, Nils ; Studt, Jan-Dirk ; Sacco, Clara ; Bertuzzi, Alexia ; Sandri, Maria Teresa ; Barco, Stefano
Assuntos: Acute Coronary Syndrome - epidemiology ; Acute Coronary Syndrome - etiology ; Aged ; Aged, 80 and over ; Ambulatory Care ; Anticoagulants - therapeutic use ; Arterial Occlusive Diseases - diagnostic imaging ; Arterial Occlusive Diseases - epidemiology ; Arterial Occlusive Diseases - etiology ; Brain Ischemia - epidemiology ; Brain Ischemia - etiology ; Cardiovascular complications ; Comorbidity ; Coronary Thrombosis - diagnostic imaging ; Coronary Thrombosis - epidemiology ; Coronary Thrombosis - etiology ; Coronavirus Infections - complications ; COVID-19 ; Critical Care ; Disseminated intravascular coagulation ; Disseminated Intravascular Coagulation - epidemiology ; Disseminated Intravascular Coagulation - etiology ; Female ; Full Length ; Hospital Mortality ; Hospitals, Teaching - statistics & numerical data ; Hospitals, Urban - statistics & numerical data ; Humans ; Italy - epidemiology ; Length of Stay - statistics & numerical data ; Male ; Middle Aged ; Mortality ; Pandemics ; Patient Admission ; Pneumonia, Viral - complications ; Pulmonary Embolism - diagnostic imaging ; Pulmonary Embolism - epidemiology ; Pulmonary Embolism - etiology ; Retrospective Studies ; Risk Factors ; SARS-CoV2 ; Thrombophilia - drug therapy ; Thrombophilia - etiology ; Venous thromboembolism ; Venous Thromboembolism - diagnostic imaging ; Venous Thromboembolism - epidemiology ; Venous Thromboembolism - etiology
É parte de: Thrombosis research, 2020-07, Vol.191, p.9-14
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Few data are available on the rate and characteristics of thromboembolic complications in hospitalized patients with COVID-19. We studied consecutive symptomatic patients with laboratory-proven COVID-19 admitted to a university hospital in Milan, Italy (13.02.2020–10.04.2020). The primary outcome was any thromboembolic complication, including venous thromboembolism (VTE), ischemic stroke, and acute coronary syndrome (ACS)/myocardial infarction (MI). Secondary outcome was overt disseminated intravascular coagulation (DIC). We included 388 patients (median age 66 years, 68% men, 16% requiring intensive care [ICU]). Thromboprophylaxis was used in 100% of ICU patients and 75% of those on the general ward. Thromboembolic events occurred in 28 (7.7% of closed cases; 95%CI 5.4%–11.0%), corresponding to a cumulative rate of 21% (27.6% ICU, 6.6% general ward). Half of the thromboembolic events were diagnosed within 24 h of hospital admission. Forty-four patients underwent VTE imaging tests and VTE was confirmed in 16 (36%). Computed tomography pulmonary angiography (CTPA) was performed in 30 patients, corresponding to 7.7% of total, and pulmonary embolism was confirmed in 10 (33% of CTPA). The rate of ischemic stroke and ACS/MI was 2.5% and 1.1%, respectively. Overt DIC was present in 8 (2.2%) patients. The high number of arterial and, in particular, venous thromboembolic events diagnosed within 24 h of admission and the high rate of positive VTE imaging tests among the few COVID-19 patients tested suggest that there is an urgent need to improve specific VTE diagnostic strategies and investigate the efficacy and safety of thromboprophylaxis in ambulatory COVID-19 patients. •COVID-19 is characterized by coagulation activation and endothelial dysfunction. Few data are available on thromboembolic complications.•We studied symptomatic patients with laboratory-proven COVID-19 admitted to a university hospital in Milan, Italy (13.02-10.04.2020).•Venous and arterial thromboembolic events occurred in 8% of hospitalized patients (cumulative rate 21.0%) and 50% of events were diagnosed within 24 h of hospital admission.•Forty-four (11% of total) patients underwent VTE imaging tests; 16 were positive (36% of tests), suggesting underestimation of thromboembolic complications.•There is an urgent need to investigate VTE diagnostic strategies and the impact of thromboprophylaxis in ambulatory COVID-19 patients.
Editor: United States: Elsevier Ltd
Idioma: Inglês

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Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy

Lodigiani, Corrado ; Iapichino, Giacomo ; Carenzo, Luca ; Cecconi, Maurizio ; Ferrazzi, Paola ; Sebastian, Tim ; Kucher, Nils ; Studt, Jan-Dirk ; Sacco, Clara ; Bertuzzi, Alexia ; Sandri, Maria Teresa ; Barco, Stefano

United States: Elsevier Ltd

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