Ecography Service in Hospital de Base-FUNFARME/FAMERP, Sao Jose do Rio Preto, Brazil.
Cardiology and Cardiovascular Surgery Department Sao Jose do Rio Preto School Medicine-FAMERP, Sao Jose do Rio Preto, Brazil.
Vasc Health Risk Manag. 2022 Nov 3;18:833-838. doi: 10.2147/VHRM.S367930. eCollection 2022.
The SARS-CoV-2 disease predisposes infected individuals to thrombosis, the underlying mechanisms of which are not fully understood. The balance between pro-coagulant factors and natural coagulation inhibitors in critically ill patients with Covid-19 is fundamental to the prevention and treatment of complications. The aim of the present study was to investigate the pulmonary injury patterns in Covid-19 having higher mortality in the presence of deep vein thrombosis in comparison to patients without venous thrombosis and determine the Gamma variant.
A retrospective study was conducted involving the evaluation of 200 medical records of patients with Covid-19 and a clinical suspicion of deep vein thrombosis (DVT) at the intensive care unit of a public hospital. The sample was divided into two groups of patients were formed - those positive and those negative for DVT. Statistical analysis involved the use of Fisher's exact test, the paired -test and chi-square test.
Patients with DVT had more severe lung injuries (greater than 70%) compared to those without DVT (p = 0.003). Lesions affecting 50% to 70% of the lung area occurred in little more half of the group with DVT and just under half in the group without DVT (p = 0.5). Pulmonary lesions affecting less than 50% of the lung occurred more in patients without DVT (p = 0.0001). The Gamma variant increased prevalence of the both DVT and mortality (p=0.0001).
Deep vein thrombosis is an aggravating factor of mortality in patients with SARS-CoV-2, and the Gamma variant is an aggravating factor of both thrombotic events and mortality.
SARS-CoV-2 疾病使感染个体易患血栓形成，其潜在机制尚不完全清楚。在 COVID-19 危重症患者中，促凝因子与天然凝血抑制剂之间的平衡对于预防和治疗并发症至关重要。本研究旨在调查 COVID-19 患者的肺部损伤模式，与无静脉血栓形成的患者相比，这些患者的死亡率更高，同时还调查了 Gamma 变异株。
本回顾性研究评估了一家公立医院重症监护病房 200 例 COVID-19 患者的病历，临床疑似深静脉血栓形成（DVT）。将样本分为两组 - DVT 阳性和 DVT 阴性患者。统计分析采用 Fisher 确切检验、配对检验和卡方检验。
与无 DVT 患者相比，DVT 患者的肺部损伤更严重（>70%）（p=0.003）。DVT 组中 50%至 70%肺部区域受累的病变发生率略高于无 DVT 组（p=0.5）。无 DVT 组中肺受累小于 50%的病变发生率更高（p=0.0001）。Gamma 变异株增加了 DVT 和死亡率的发生率（p=0.0001）。
深静脉血栓形成是 SARS-CoV-2 患者死亡的加重因素，Gamma 变异株是血栓形成事件和死亡率的加重因素。
