Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia

J Thromb Haemost. 2020 Jun;18(6):1421-1424. doi: 10.1111/jth.14830. Epub 2020 May 6.

Abstract

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 µg/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.

Keywords: D-dimer; blood coagulation; coagulation parameter; novel coronavirus pneumonia; venous thromboembolism.

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus / pathogenicity*
  • Biomarkers / blood
  • Blood Coagulation Tests
  • Blood Coagulation*
  • China / epidemiology
  • Coronavirus Infections / blood
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / virology
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / virology
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Venous Thromboembolism / blood
  • Venous Thromboembolism / diagnosis
  • Venous Thromboembolism / epidemiology*
  • Venous Thromboembolism / virology

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2