Incidence of deep venous thrombosis in patients with severe acute respiratory syndrome coronavirus disease 2019 and elevated plasma levels of the D-dimer

Khaled Attia, M. Ibrahim, A. Abonar
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Abstract

Background There is an increased risk of developing venous thromboembolism in patients with severe acute respiratory syndrome coronavirus disease (SARS COVID-19). As the D-dimer could be elevated in deep venous thrombosis (DVT), we aimed to investigate the incidence of DVT in patients with SARS COVID-19 and elevated plasma levels of the D-dimer. Patients and methods A prospective observational study was carried out to screen all patients with a confirmed diagnosis of SARS COVID-19 with plasma D-dimer levels above 1000 ng/ml for the presence of DVT without related symptoms using complete compression Doppler ultrasound. Results A total of 52 patients were included in the study. Among them, 34 (67.3%) were males. All patients received standardized thromboprophylaxis treatment. The screening results of complete compression Doppler ultrasound revealed DVT in eight (15.4%) patients. Among these patients, the DVT was proximal in one (1.9%) patient and bilateral distal in two (3.8%) patients. The D-dimer level was significantly higher in patients with DVT than in patients without DVT (4531 vs. 2048 ng/ml, odds ratio 9.4, 95% confidence interval 1.2–70.3). The diagnostic ability of the D-dimer was satisfactory, with an receiver operating characteristic curve of 0.71 (95% confidence interval 0.62–0.83). Conclusion The incidence of DVT without symptoms in patients with SARS COVID-19 and elevated plasma level of D-dimer was 15.4%, with a significant difference between patients with and without DVT in terms of the D-dimer. Therefore, the D-dimer is important for the diagnosis of DVT in patients with SARS COVID-19.
2019年严重急性呼吸综合征冠状病毒病患者深静脉血栓发生率与血浆d -二聚体水平升高
背景严重急性呼吸综合征冠状病毒病(SARS - COVID-19)患者发生静脉血栓栓塞的风险增加。由于d -二聚体可能在深静脉血栓形成(DVT)中升高,我们旨在研究SARS - COVID-19患者DVT的发病率和d -二聚体的血浆水平升高。患者和方法采用前瞻性观察研究,采用全压缩多普勒超声筛查所有确诊为SARS COVID-19且血浆d -二聚体水平高于1000 ng/ml的患者是否存在DVT,且无相关症状。结果共纳入52例患者。其中男性34例(67.3%)。所有患者均接受标准化的血栓预防治疗。全压缩多普勒超声筛查显示DVT 8例(15.4%)。在这些患者中,近端DVT 1例(1.9%),远端DVT 2例(3.8%)。DVT患者的d -二聚体水平明显高于无DVT患者(4531 vs 2048 ng/ml,优势比9.4,95%可信区间1.2-70.3)。d -二聚体的诊断能力令人满意,受试者工作特征曲线为0.71(95%可信区间为0.62-0.83)。结论SARS - COVID-19患者无症状DVT及血浆d -二聚体水平升高的发生率为15.4%,有与无DVT患者d -二聚体水平差异有统计学意义。因此,d -二聚体对SARS - COVID-19患者DVT的诊断具有重要意义。
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