Incidence, risk factors, and thrombotic load of pulmonary embolism in patients hospitalized for COVID-19 infection.
Incidence, risk factors, and thrombotic load of pulmonary embolism in patients hospitalized for COVID-19 infection.
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因COVID-19感染住院患者肺栓塞的发病率、风险因素和血栓负荷。
DOI：
10.1016/j.jinf.2021.01.003
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Martínez-García MÁ
中科院分区：
文献类型：
--
作者：
García-Ortega A;Oscullo G;Calvillo P;López-Reyes R;Méndez R;Gómez-Olivas JD;Bekki A;Fonfría C;Trilles-Olaso L;Zaldívar E;Ferrando A;Anguera G;Briones-Gómez A;Reig-Mezquida JP;Feced L;González-Jiménez P;Reyes S;Muñoz-Núñez CF;Carreres A;Gil R;Morata C;Toledo-Pons N;Martí-Bonmati L;Menéndez R;Martínez-García MÁ
确定因COVID-19住院患者中肺栓塞（PE）的发病率、特征和风险因素。我们对2020年3月8日至2020年4月25日期间因COVID-19感染住院的连续患者的随机选择队列进行了前瞻性观察性研究。所有符合条件的患者均接受了计算机断层扫描肺血管造影，与其PE临床怀疑无关，并对基线D-二聚体水平升高进行了预筛选。在研究期间，从瓦伦西亚（西班牙）一家三级医院因COVID-19感染入院的372名患者中随机选择了119名患者。73例患者符合入选标准，但不符合任何排除标准，最终入选研究。尽管药物血栓预防水平较高（89%），但PE的发生率为35.6%（95%置信区间[CI]，29.6 - 41.6%），主要发生在外周部位和低血栓负荷（Qanadli评分18.5%）。多变量分析显示，入院时的心率（风险比[HR]，1.04）、室内空气氧饱和度（spO 2）（HR，0.87）、D-二聚体（HR，1.02）和C-反应蛋白（CRP）水平（HR，1.01）是住院期间PE事件的独立预测因素。使用这四个变量构建风险评分，显示PE事件的高预测值（AUC-ROC：0.86; 95% CI：0.80 - 0.93）。我们的研究结果证实了住院COVID-19患者中PE的高发病率。入院时的心率、SpO 2、D-二聚体和CRP水平与住院期间较高的PE发生率相关。
To determine the incidence, characteristics, and risk factors of pulmonary embolism (PE) among patients hospitalized for COVID-19. We performed a prospective observational study of a randomly selected cohort of consecutive patients hospitalized for COVID-19 infection between March 8, 2020 through April 25, 2020. All eligible patients underwent a computed tomography pulmonary angiography independently of their PE clinical suspicion and were pre-screened for a baseline elevated D-dimer level. 119 patients were randomly selected from the 372 admitted to one tertiary hospital in Valencia (Spain) for COVID-19 infection during the period of study. Seventy-three patients fulfilled both the inclusion criteria and none of the exclusion criteria and were finally included in the study. Despite a high level of pharmacological thromboprophylaxis (89%), the incidence of PE was 35.6% (95% confidence interval [CI], 29.6 to 41.6%), mostly with a peripheral location and low thrombotic load (Qanadli score 18.5%). Multivariate analysis showed that heart rate (Hazard Ratio [HR], 1.04), room-air oxygen saturation (spO2) (HR, 0.87), D-dimer (HR, 1.02), and C-reactive protein (CRP) levels (HR, 1.01) at the time of admission were independent predictors of incident PE during hospitalization. A risk score was constructed with these four variables showing a high predictive value of incident PE (AUC-ROC: 0.86; 95% CI: 0.80 to 0.93). Our findings confirmed a high incidence of PE in hospitalized COVID-19 patients. Heart rate, spO2, D-dimer, and CRP levels at admission were associated with higher rates of PE during hospitalization.
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影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
4.6
作者：
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通讯作者：
Delaloye, Julie
DOI：
10.1111/jth.14849
发表时间：
2020-07
期刊：
Journal of thrombosis and haemostasis : JTH
影响因子：
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作者：
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影响因子：
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作者：
Jiménez D;García-Sanchez A;Rali P;Muriel A;Bikdeli B;Ruiz-Artacho P;Le Mao R;Rodríguez C;Hunt BJ;Monreal M
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影响因子：
7.3
作者：
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