COVID-19 肺炎非危重症患者的深静脉血栓形成：非重症监护病房患者的深静脉血栓形成。
Deep vein thrombosis in noncritically ill patients with coronavirus disease 2019 pneumonia: deep vein thrombosis in nonintensive care unit patients.
机构信息
Angiology and Vascular Surgery Unit, Bellvitge University Hospital, Hospitalet del Llobregat, Spain.
Angiology and Vascular Surgery Unit, Bellvitge University Hospital, Hospitalet del Llobregat, Spain.
出版信息
J Vasc Surg Venous Lymphat Disord. 2021 May;9(3):592-596. doi: 10.1016/j.jvsv.2020.08.028. Epub 2020 Sep 7.
BACKGROUND
Venous thromboembolic events have been one of the main causes of mortality among hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia. The aim of our study was to describe the prevalence of deep vein thrombosis (DVT) in noncritically ill patients with COVID-19 pneumonia and correlate such observations with the thromboprophylaxis received.
METHODS
We performed a prospective cohort study of 67 patients admitted to the hospital for COVID-19 pneumonia. The diagnosis was confirmed using polymerase chain reaction testing of nasopharyngeal specimens. The deep veins were examined using compression duplex ultrasonography with the transducer on B-mode. The patients were separated into two groups for statistical analysis: those receiving low-molecular-weight heparin prophylaxis and those receiving intermediate or complete anticoagulation treatment. Risk analysis and logistic regression were performed.
RESULTS
Of the 67 patients, 57 were included in the present study after applying the inclusion and exclusion criteria; 49.1% were women, and the patient mean age was 71.3 years. All 57 patients had undergone compression duplex ultrasonography. Of these 57 patients, 6 were diagnosed with DVT, for an in-hospital rate of DVT in patients with COVID-19 pneumonia of 10.5%. All the patients who had presented with DVT had been receiving low-molecular-weight heparin prophylaxis. The patients receiving prophylactic anticoagulation treatment had a greater risk of DVT (16.21%; 95% confidence interval, 0.04-0.28; P = .056) compared with those receiving intermediate or complete anticoagulation treatment. We also found a protective factor for DVT in the intermediate or complete anticoagulation treatment group (odds ratio, 0.19; 95% confidence interval, 0.08-0.46; P < .05).
CONCLUSIONS
Noncritically ill, hospitalized patients with COVID-19 pneumonia have a high risk of DVT despite receipt of correct, standard thromboprophylaxis.
背景
静脉血栓栓塞事件一直是新冠肺炎住院患者死亡的主要原因之一。我们的研究目的是描述非危重症新冠肺炎患者中深静脉血栓形成（DVT）的发生率，并将这些观察结果与接受的血栓预防措施相关联。
方法
我们对 67 名因新冠肺炎住院的患者进行了前瞻性队列研究。通过对鼻咽标本进行聚合酶链反应检测来确诊。使用 B 模式下的压缩双功能超声检查深静脉。将患者分为两组进行统计分析：接受低分子肝素预防治疗组和接受中或完全抗凝治疗组。进行风险分析和逻辑回归分析。
结果
在应用纳入和排除标准后，67 名患者中有 57 名被纳入本研究；女性占 49.1%，患者平均年龄为 71.3 岁。所有 57 名患者均接受了压缩双功能超声检查。在这 57 名患者中，有 6 名被诊断为 DVT，COVID-19 肺炎患者的院内 DVT 发生率为 10.5%。所有出现 DVT 的患者均接受了低分子肝素预防治疗。与接受中或完全抗凝治疗的患者相比，接受预防性抗凝治疗的患者 DVT 风险更高（16.21%；95%置信区间，0.04-0.28；P=0.056）。我们还发现，中或完全抗凝治疗组是 DVT 的保护因素（比值比，0.19；95%置信区间，0.08-0.46；P<0.05）。
结论
尽管接受了正确的标准血栓预防措施，非危重症新冠肺炎住院患者仍存在发生 DVT 的高风险。
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