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Viruses 2021 ; 13 (5): ? Nephropedia Template TP
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D-Dimer Level and Neutrophils Count as Predictive and Prognostic Factors of Pulmonary Embolism in Severe Non-ICU COVID-19 Patients #MMPMID33926038
Thoreau B; Galland J; Delrue M; Neuwirth M; Stepanian A; Chauvin A; Dellal A; Nallet O; Roriz M; Devaux M; London J; Martin-Lecamp G; Froissart A; Arab N; Ferron B; Groff MH; Queyrel V; Lorut C; Regard L; Berthoux E; Bayer G; Comarmond C; Lioger B; Mekinian A; Szwebel TA; Sene T; Amador-Borrero B; Mangin O; Sellier PO; Siguret V; Mouly S; Kevorkian JP; Lariboisiere Covid Group; Vodovar D; Sene D
Viruses 2021[Apr]; 13 (5): ? PMID33926038show ga
The incidence of pulmonary embolism (PE) is high during severe Coronavirus Disease 2019 (COVID-19). We aimed to identify predictive and prognostic factors of PE in non-ICU hospitalized COVID-19 patients. In the retrospective multicenter observational CLOTVID cohort, we enrolled patients with confirmed RT-PCR COVID-19 who were hospitalized in a medicine ward and also underwent a CT pulmonary angiography for a PE suspicion. Baseline data, laboratory biomarkers, treatments, and outcomes were collected. Predictive and prognostics factors of PE were identified by using logistic multivariate and by Cox regression models, respectively. A total of 174 patients were enrolled, among whom 86 (median [IQR] age of 66 years [55-77]) had post-admission PE suspicion, with 30/86 (34.9%) PE being confirmed. PE occurrence was independently associated with the lack of long-term anticoagulation or thromboprophylaxis (OR [95%CI], 72.3 [3.6-4384.8]) D-dimers >/= 2000 ng/mL (26.3 [4.1-537.8]) and neutrophils >/= 7.0 G/L (5.8 [1.4-29.5]). The presence of these two biomarkers was associated with a higher risk of PE (p = 0.0002) and death or ICU transfer (HR [95%CI], 12.9 [2.5-67.8], p < 0.01). In hospitalized non-ICU severe COVID-19 patients with clinical PE suspicion, the lack of anticoagulation, D-dimers >/= 2000 ng/mL, neutrophils >/= 7.0 G/L, and these two biomarkers combined might be useful predictive markers of PE and prognosis, respectively.