Ferreira Ronney Argolo, Zanatta Lian, Oliveira Juliane Bispo de, Gomes Janaina Ibele Carvalho, Ritt Luiz, Rocha Ana Thereza Cavalcanti
. Faculdade de Medicina, Universidade Federal da Bahia, Salvador (BA), Brasil.
. Escola Baiana de Medicina e Saúde Pública, Salvador (BA), Brasil.
J Bras Pneumol. 2025 Mar 31;51(1):e20240042. doi: 10.36416/1806-3756/e20240042. eCollection 2025.
To evaluate the incidence of venous thromboembolism (VTE) in hospitalized patients with COVID-19 who underwent diagnostic tests for suspected VTE, and to correlate the IMPROVE-DD score with the incidence of VTE in this cohort.
This retrospective study included consecutive patients with COVID-19 and suspected VTE, admitted between March 2020 and September 2021 at a private hospital in Salvador (BA), Brazil, who underwent lower or upper limb venous Doppler ultrasound or chest angiotomography. Descriptive analyses and comparisons using the chi-square test were performed to identify factors potentially associated with the risk of VTE.
A total of 517 patients were included, with an in-hospital VTE incidence of 18.6% (96 events). Risk factors significantly associated with VTE included obesity, ICU admission, central venous catheter use, longer hospital stays, greater lung tomographic involvement/severity, the need for mechanical ventilation, D-dimer levels at least twice the upper limit of normal (2xULN), and the IMPROVE-DD score. The mean IMPROVE-DD score among patients with VTE was 4.7 (±3) versus 3.3 (±2.4) in those without VTE (p < 0.0001). D-dimer 2xULN was sensitive in identifying 94% of the 96 patients with VTE (p < 0.0001). The in-hospital mortality rate was 14.1%, with higher rates observed in patients with VTE (24%) compared to those without VTE (11.9%) (p = 0.003).
The incidence of VTE in hospitalized COVID-19 patients was high and correlated with increased mortality. The IMPROVE-DD score effectively identified patients at risk for in-hospital VTE, suggesting it could help to identify a high-risk subgroup that may benefit from extended thromboprophylaxis.
评估因疑似静脉血栓栓塞症（VTE）而接受诊断检查的新冠肺炎住院患者中VTE的发生率，并将IMPROVE-DD评分与该队列中VTE的发生率进行关联分析。
这项回顾性研究纳入了2020年3月至2021年9月期间在巴西巴伊亚州萨尔瓦多市一家私立医院住院的连续的新冠肺炎疑似VTE患者，这些患者接受了下肢或上肢静脉多普勒超声检查或胸部血管造影检查。采用卡方检验进行描述性分析和比较，以确定可能与VTE风险相关的因素。
共纳入517例患者，住院期间VTE发生率为18.6%（96例事件）。与VTE显著相关的危险因素包括肥胖、入住重症监护病房、使用中心静脉导管、住院时间延长、肺部断层扫描累及范围/严重程度增加、需要机械通气、D-二聚体水平至少为正常上限的两倍（2倍ULN）以及IMPROVE-DD评分。VTE患者的平均IMPROVE-DD评分为4.7（±3），而无VTE患者为3.3（±2.4）（p<0.0001）。D-二聚体2倍ULN在识别96例VTE患者中的94%时具有敏感性（p<0.0001）。住院死亡率为14.1%，VTE患者的死亡率（24%）高于无VTE患者（[11.9%]）（p = 0.003）。
新冠肺炎住院患者中VTE的发生率较高，且与死亡率增加相关。IMPROVE-DD评分有效地识别了住院VTE风险患者，表明它有助于识别可能从延长血栓预防中获益的高危亚组。
