Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital

ABSTRACT: Objectives: To describe the incidence of thromboembolic events in adult patients with severe COVID-19 and identify clinical and laboratory factors associated with these events. Design: Observational retrospective cohort study of 243 adult patients with severe COVID-19 admitted to an inten...

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Autores principales:	Antonio Adolfo Guerra Soares Brandão, Cleyton Zanardo de Oliveira, Salomon Ordinola Rojas, Amanda Ayako Minemura Ordinola, Victoria Masi Queiroz, Danielle Leão Cordeiro de Farias, Phillip Scheinberg, Viviane Cordeiro Veiga
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	COVID-19 intensive care unit thrombosis D-dimer survival Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/dd48be2d2a904564a51518f19135dfe1
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spelling	oai:doaj.org-article:dd48be2d2a904564a51518f19135dfe12021-11-12T04:27:24ZThromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital1201-971210.1016/j.ijid.2021.10.020https://doaj.org/article/dd48be2d2a904564a51518f19135dfe12021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1201971221008122https://doaj.org/toc/1201-9712ABSTRACT: Objectives: To describe the incidence of thromboembolic events in adult patients with severe COVID-19 and identify clinical and laboratory factors associated with these events. Design: Observational retrospective cohort study of 243 adult patients with severe COVID-19 admitted to an intensive care unit (ICU) at a Brazilian tertiary hospital. Results: The incidence of all thromboembolic events was 14.8%, in which 3.8% developed deep vein thrombosis, 7.8% pulmonary embolism, 2.5% acute myocardial infarction, 1.2% stroke, and 1.2% peripheral artery occlusion. Risk factors identified were D-dimer at admission >3000 ng/mL (P=<0.0013) and major bleeding (P=0.001). The cumulative risk of developing thromboembolic events at day 28 after ICU admission was 16.0%. The rate of major bleeding was 4.1%. After receiver operating characteristic curve analysis, the D-dimer cut-off at admission correlating with thromboembolic events was 1140.5 ng/mL. Conclusions: The rate of thromboembolic events in our study was lower than previously described. High D-dimer level at admission was the leading risk factor; the optimal cut-off was 1140.5 ng/mL. The occurrence of thromboembolic events did not have an impact on the median overall survival rate. The optimal anticoagulant strategy in this context still needs to be established.Antonio Adolfo Guerra Soares BrandãoCleyton Zanardo de OliveiraSalomon Ordinola RojasAmanda Ayako Minemura OrdinolaVictoria Masi QueirozDanielle Leão Cordeiro de FariasPhillip ScheinbergViviane Cordeiro VeigaElsevierarticleCOVID-19intensive care unitthrombosisD-dimersurvivalInfectious and parasitic diseasesRC109-216ENInternational Journal of Infectious Diseases, Vol 113, Iss , Pp 236-242 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 intensive care unit thrombosis D-dimer survival Infectious and parasitic diseases RC109-216
spellingShingle	COVID-19 intensive care unit thrombosis D-dimer survival Infectious and parasitic diseases RC109-216 Antonio Adolfo Guerra Soares Brandão Cleyton Zanardo de Oliveira Salomon Ordinola Rojas Amanda Ayako Minemura Ordinola Victoria Masi Queiroz Danielle Leão Cordeiro de Farias Phillip Scheinberg Viviane Cordeiro Veiga Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital
description	ABSTRACT: Objectives: To describe the incidence of thromboembolic events in adult patients with severe COVID-19 and identify clinical and laboratory factors associated with these events. Design: Observational retrospective cohort study of 243 adult patients with severe COVID-19 admitted to an intensive care unit (ICU) at a Brazilian tertiary hospital. Results: The incidence of all thromboembolic events was 14.8%, in which 3.8% developed deep vein thrombosis, 7.8% pulmonary embolism, 2.5% acute myocardial infarction, 1.2% stroke, and 1.2% peripheral artery occlusion. Risk factors identified were D-dimer at admission >3000 ng/mL (P=<0.0013) and major bleeding (P=0.001). The cumulative risk of developing thromboembolic events at day 28 after ICU admission was 16.0%. The rate of major bleeding was 4.1%. After receiver operating characteristic curve analysis, the D-dimer cut-off at admission correlating with thromboembolic events was 1140.5 ng/mL. Conclusions: The rate of thromboembolic events in our study was lower than previously described. High D-dimer level at admission was the leading risk factor; the optimal cut-off was 1140.5 ng/mL. The occurrence of thromboembolic events did not have an impact on the median overall survival rate. The optimal anticoagulant strategy in this context still needs to be established.
format	article
author	Antonio Adolfo Guerra Soares Brandão Cleyton Zanardo de Oliveira Salomon Ordinola Rojas Amanda Ayako Minemura Ordinola Victoria Masi Queiroz Danielle Leão Cordeiro de Farias Phillip Scheinberg Viviane Cordeiro Veiga
author_facet	Antonio Adolfo Guerra Soares Brandão Cleyton Zanardo de Oliveira Salomon Ordinola Rojas Amanda Ayako Minemura Ordinola Victoria Masi Queiroz Danielle Leão Cordeiro de Farias Phillip Scheinberg Viviane Cordeiro Veiga
author_sort	Antonio Adolfo Guerra Soares Brandão
title	Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital
title_short	Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital
title_full	Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital
title_fullStr	Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital
title_full_unstemmed	Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital
title_sort	thromboembolic and bleeding events in intensive care unit patients with covid-19: results from a brazilian tertiary hospital
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/dd48be2d2a904564a51518f19135dfe1
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Thromboembolic and bleeding events in intensive care unit patients with COVID-19: results from a Brazilian tertiary hospital

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