Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia
Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia
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DOI：
10.1111/jth.14830
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发表时间：
2020-05-06
影响因子：
10.4
通讯作者：
Wang, Feng
中科院分区：
文献类型：
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作者：
Cui, Songping;Chen, Shuo;Wang, Feng
背景 三个月前，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在中国武汉爆发，并在全球迅速传播。新型冠状病毒肺炎（NCP）重症患者存在凝血功能异常，但其静脉血栓栓塞（VTE）患病率仍很少被提及。 目的 明确重症NCP患者VTE的发生率。 方法 本研究纳入协和医院（中国武汉）重症监护病房（ICU）的81例重症NCP患者。回顾性收集并分析这些患者的常规凝血参数和下肢静脉超声检查结果。结果这些患者VTE发生率为25%（20/81），其中8例VTE事件患者死亡。 VTE组与非VTE组在年龄、淋巴细胞计数、活化部分凝血活酶时间（APTT）、D-二聚体等方面存在差异。若以1.5μg/mL作为D-二聚体临界值预测VTE，其敏感性为85.0%，特异性为88.5%，阴性预测值（NPV）为94.7%。结论 重症NCP患者VTE发生率为25%（20/81），可能与预后不良有关。重症NCP患者D-二聚体显着升高是识别VTE高危人群的良好指标。
Background Three months ago, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out in Wuhan, China, and spread rapidly around the world. Severe novel coronavirus pneumonia (NCP) patients have abnormal blood coagulation function, but their venous thromboembolism (VTE) prevalence is still rarely mentioned.Objectives To determine the incidence of VTE in patients with severe NCP.Methods In this study, 81 severe NCP patients in the intensive care unit (ICU) of Union Hospital (Wuhan, China) were enrolled. The results of conventional coagulation parameters and lower limb vein ultrasonography of these patients were retrospectively collected and analyzed.Results The incidence of VTE in these patients was 25% (20/81), of which 8 patients with VTE events died. The VTE group was different from the non-VTE group in age, lymphocyte counts, activated partial thromboplastin time (APTT), D-dimer, etc. If 1.5 mu g/mL was used as the D-dimer cut-off value to predicting VTE, the sensitivity was 85.0%, the specificity was 88.5%, and the negative predictive value (NPV) was 94.7%.Conclusions The incidence of VTE in patients with severe NCP is 25% (20/81), which may be related to poor prognosis. The significant increase of D-dimer in severe NCP patients is a good index for identifying high-risk groups of VTE.