Brighton and Sussex University Hospitals NHS Trust, Brighton, UK and Brighton and Sussex Medical School, Falmer, UK
Brighton and Sussex Medical School, Brighton, UK and Royal Sussex County Hospital, Brighton, UK.
Clin Med (Lond). 2020 Jul;20(4):e76-e81. doi: 10.7861/clinmed.2020-0228. Epub 2020 May 18.
A possible association between COVID-19 infection and thrombosis, either as a direct consequence of the virus or as a complication of inflammation, is emerging in the literature. Data on the incidence of venous thromboembolism (VTE) are extremely limited.
We describe three cases of thromboembolism refractory to heparin treatment, the incidence of VTE in an inpatient cohort, and a case-control study to identify risk factors associated with VTE.
We identified 274 confirmed (208) or probable (66) COVID-19 patients. 21 (7.7%) were diagnosed with VTE. D-dimer was elevated in both cases (confirmed VTE) and controls (no confirmed VTE) but higher levels were seen in confirmed VTE cases (4.1 vs 1.2 μg/mL, p<0.001).
Incidence of VTE is high in patients hospitalised with COVID-19. Urgent clinical trials are needed to evaluate the role of anticoagulation in COVID-19. Monitoring of D-dimer and anti-factor Xa levels may be beneficial in guiding management.
COVID-19 感染与血栓之间可能存在关联，这种关联可能是病毒的直接后果，也可能是炎症的并发症。文献中出现了这种关联的相关数据。静脉血栓栓塞症（VTE）的发病率数据极其有限。
我们描述了三例肝素治疗无效的血栓栓塞病例，住院患者队列中的 VTE 发病率，以及一项病例对照研究，以确定与 VTE 相关的危险因素。
我们确定了 274 例确诊（208 例）或可能（66 例）COVID-19 患者。21 例（7.7%）被诊断为 VTE。两种情况下 D-二聚体均升高（确诊 VTE 组和对照组），但确诊 VTE 组的水平更高（4.1μg/ml 比 1.2μg/ml，p<0.001）。
COVID-19 住院患者的 VTE 发病率较高。迫切需要进行临床试验来评估抗凝在 COVID-19 中的作用。监测 D-二聚体和抗因子 Xa 水平可能有助于指导治疗。
