Risk Factors of Venous Thromboembolism in Noncritically Ill Patients Hospitalized for Acute COVID-19 Pneumonia Receiving Prophylactic-Dose Anticoagulation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Data Collection
2.3. Laboratory Procedures
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total (n = 208) | VTE (n = 37) | Non-VTE (n = 171) | p-Value | |
---|---|---|---|---|
Age, years | 77 (66–86) | 71 (61–81) | 78 (69–86) | 0.004 |
Sex | ||||
Female | 110 (53%) | 15 (41%) | 95 (56%) | 0.09 |
Male | 98 (47%) | 22 (59%) | 76 (44%) | - |
Body Mass Index | 26 (23–31) | 29 (27–31) | 26 (23–29) | 0.002 |
Comorbidity | ||||
Hypertension | 131 (63%) | 28 (76%) | 103 (60%) | 0.08 |
Diabetes | 39 (19%) | 7 (19%) | 32 (19%) | 0.98 |
Coronary heart disease | 11 (5%) | 2 (5%) | 9 (5%) | 0.97 |
Cerebrovascular disease | 25 (12%) | 4 (11%) | 21 (12%) | 0.8 |
Previous thrombotic events | 13 (6%) | 3 (8%) | 10 (6%) | 0.61 |
Active cancer | 30 (14%) | 8 (22%) | 22 (13%) | 0.17 |
Chronic kidney disease | 43 (21%) | 7 (19%) | 36 (21%) | 0.77 |
Blood group | ||||
A | 83 (40%) | 19 (51%) | 64 (37%) | 0.12 |
B | 28 (13%) | 5 (14%) | 23 (13%) | 0.99 |
AB | 12 (6%) | 3 (8%) | 9 (5%) | 0.5 |
O | 85 (41%) | 10 (27%) | 75 (44%) | 0.06 |
Padua prediction score | 4 (3–6) | 3 (3–5) | 4 (3–6) | 0.03 |
≥4 | 118 (57%) | 13 (35%) | 105 (61%) | 0.04 |
SOFA score | 2 (2–3) | 3 (2–3) | 2 (1–3) | 0.06 |
≥2 | 158 (76%) | 32 (86%) | 126 (74%) | 0.09 |
SIC score | 2 (2–3) | 2 (2–3) | 2 (2–3) | 0.49 |
≥4 | 29 (14%) | 5 (14%) | 24 (14%) | 0.93 |
PaO2/FIO2, mmHg | 272 (222–314) | 258 (195–272) | 277 (232–320) | 0.03 |
<300 | 138 (66%) | 29 (78%) | 109 (64%) | 0.09 |
Total (n = 208) | VTE (n = 37) | Non-VTE (n = 171) | p-Value | |
---|---|---|---|---|
Laboratory findings | ||||
White blood cell count, ×109 per L | 7 (5–11) | 9 (6–11) | 6.9 (5–11) | 0.82 |
>10 | 60 (29%) | 12 (32%) | 48 (28%) | 0.59 |
Lymphocyte count, ×109 per L | 1.0 (0.7–1.3) | 1.1 (0.6–1.6) | 1.0 (0.7–1.2) | 0.97 |
<0.8 | 74 (36%) | 14 (38%) | 60 (35%) | 0.75 |
Hemoglobin, g/L | 124 (110–137) | 128 (117–138) | 123 (107–137) | 0.12 |
<120 g/L | 91 (44%) | 11 (30%) | 80 (47%) | 0.06 |
Platelet count, ×109 per L | 215 (173–284) | 208 (177–279) | 215 (171–285) | 0.82 |
<100 | 17 (8%) | 1 (3%) | 16 (9%) | 0.18 |
Prothrombin time, s | 11 (9–16) | 13 (10–16) | 12 (9–15) | 0.15 |
Activated partial thromboplastin time, s | 24 (22–26) | 24 (21–25) | 24 (22–27) | 0.09 |
D-dimer, ng/mL | 298 (169–657) | 317 (197–1093) | 289 (161–603) | 0.32 |
>500 | 71 (34%) | 14 (38%) | 57 (33%) | 0.6 |
Fibrinogen, g/L | 4.9 (4.2–5.4) | 5.2 (4.7–6.0) | 4.9 (4.2–5.4) | 0.76 |
>4.5 | 135 (65%) | 28 (76%) | 107 (63%) | 0.13 |
Antithrombin, % | 93 (84–103) | 95 (85–107) | 92 (83–103) | 0.25 |
<70 | 7 (3%) | 2 (5%) | 5 (3%) | 0.45 |
Factor VIII, % | 196 (146–253) | 220 (167–248) | 195 (144–254) | 0.33 |
>200 | 100 (48%) | 21 (57%) | 79 (46%) | 0.24 |
Von Willebrand factor, % | 299 (242–392) | 277 (247–473) | 299 (242–381) | 0.58 |
>200 | 197 (95%) | 36 (97%) | 161 (94%) | 0.44 |
WB hypercoagulable profile | 150 (72%) | 28 (75%) | 112 (69%) | 0.23 |
WB platelet hyper-reactivity | 141 (68%) | 26 (70%) | 113 (66%) | 0.62 |
Creatinine, mg/dL | 0.9 (0.7–1.2) | 1.0 (0.7–1.2) | 0.9 (0.7–1.2) | 0.62 |
>1.2 | 47 (23%) | 9 (24%) | 38 (22%) | 0.78 |
Serum ferritin, μg/L | 584 (352–931) | 663 (476–1050) | 575 (335–894) | 0.22 |
>300 | 169 (81%) | 33 (89%) | 136 (80%) | 0.17 |
IL-6, pg/mL | 56 (27–82) | 47 (21–74) | 56 (27–82) | 0.95 |
>82 | 53 (25%) | 9 (24%) | 44 (26%) | 0.86 |
C-reactive protein, mg/L | 66 (28–110) | 58 (15–100) | 66 (29–110) | 0.35 |
>110 | 49 (24%) | 7 (19%) | 42 (25%) | 0.46 |
Procalcitonin, ng/mL | 0.11 (0.04–0.36) | 0.10 (0.04–0.23) | 0.12 (0.05–0.4) | 0.96 |
>0.36 | 49 (24%) | 5 (14%) | 44 (26%) | 0.11 |
Radiographic findings | ||||
Consolidation | 21 (10%) | 2 (5%) | 19 (11%) | 0.29 |
Ground-glass opacity | 49 (24%) | 6 (16%) | 43 (25%) | 0.25 |
Bilateral pulmonary | 94 (45%) | 25 (68%) | 69 (40%) | 0.02 |
Infiltration |
Univariable RR (95% CI) | p-Value | Multivariable RR (95% CI) | p-Value | |
---|---|---|---|---|
Demographics and clinical characteristics | ||||
Age, years | ||||
38–71 | 1 (ref) | 1 (ref) | ||
72–82 | 0.89 (0.47–1.69) | 0.72 | - | - |
83–100 | 0.47 (0.22–1.02) | 0.05 | 0.52 (0.20–1.05) | 0.07 |
Female sex (vs. male) | 0.61 (0.33–1.10) | 0.09 | 0.68 (0.29–1.12) | 0.11 |
Body Mass Index (BMI) | ||||
<30 | 1 (ref) | 1 (ref) | ||
≥30 | 1.85 (1.04–3.31) | 0.04 | 1.75 (1.02–3.36) | 0.04 |
Comorbidity present (vs. not present) | ||||
Hypertension | 1.83 (0.91–3.67) | 0.08 | 1.78 (1.01–3.73) | 0.09 |
Diabetes | 1.01 (0.48–2.13) | 0.98 | - | - |
Coronary heart disease | 1.02 (0.28–3.71) | 0.97 | - | - |
Cerebrovascular disease | 0.89 (0.34–2.29) | 0.8 | - | - |
Previous thromboembolic event | 1.32 (0.47–3.74) | 0.61 | - | - |
Active cancer | 1.64 (0.83–3.23) | 0.17 | - | - |
Chronic kidney disease | 0.90 (0.42–1.90) | 0.77 | - | - |
Blood group O (vs. non-O) | 0.54 (0.27–1.05) | 0.06 | 0.48 (0.22–1.15) | 0.08 |
Padua prediction score | ||||
<4 | 1 (ref) | 1 (ref) | ||
≥4 | 0.41 (0.22–0.77) | 0.04 | 0.54 (0.17–0.81) | 0.04 |
SOFA score | ||||
<2 | 1 (ref) | 1 (ref) | ||
≥2 | 2.03 (0.83–4.92) | 0.09 | 2.07 (0.66–5.01) | 0.13 |
SIC score | ||||
<4 | 1 (ref) | |||
≥4 | 0.96 (0.41–2.27) | 0.93 | - | - |
PaO2/FIO2, mmHg | ||||
≥300 | 1 (ref) | 1 (ref) | ||
<300 | 1.84 (0.89–3.81) | 0.09 | 1.91 (0.77–3.96) | 0.11 |
Laboratory findings | ||||
White blood cell count, ×109 per L | ||||
≤10 | 1 (ref) | |||
>10 | 1.18 (0.64–2.2) | 0.59 | - | - |
Lymphocyte count, ×109 per L | ||||
≥0.8 | 1 (ref) | |||
<0.8 | 1.1 (0.6–2.01) | 0.75 | - | - |
Hemoglobin, g/L | ||||
≥12 | 1 (ref) | 1 (ref) | ||
<12 | 0.54 (0.28–1.04) | 0.06 | 0.47 (0.31–1.18) | 0.07 |
Platelet count, ×109 per L | ||||
≥100 | 1 (ref) | |||
<100 | 0.31 (0.05–2.14) | 0.18 | - | - |
Prothrombin time, s | ||||
≥12 | 1 (ref) | |||
<12 | 0.37 (0.21–1.23) | 0.31 | - | - |
Activated partial thromboplastin time, s | ||||
<26 | 1 (ref) | |||
≥26 | 0.55 (0.26–1.18) | 0.17 | - | - |
D-dimer, ng/mL | ||||
≤500 | 1 (ref) | |||
>500 | 1.17 (0.64–2.14) | 0.6 | - | - |
Factor VIII, % | ||||
≤200 | 1 (ref) | |||
>200 | 1.42 (0.79–2.56) | 0.24 | - | - |
Von Willebrand factor, % | ||||
≤200 | 1 (ref) | |||
>200 | 2.01 (0.3–13.33) | 0.44 | - | - |
WB hypercoagulable profile (vs. other profiles) | 1.51 (0.76–3.02) | 0.23 | - | - |
WB platelet hyper-reactivity (vs. other profiles) | 1.17 (0.62–2.23) | 0.62 | - | - |
Creatinine, mg/dL | ||||
≤1.2 | 1 (ref) | |||
>1.2 | 1.10 (0.56–2.17) | 0.78 | - | - |
Serum ferritin, μg/L | ||||
≤300 | 1 (ref) | |||
>300 | 1.90 (0.72–5.06) | 0.17 | - | - |
IL-6, pg/mL | ||||
≤82 | 1 (ref) | |||
>82 | 0.94 (0.47–1.86) | 0.86 | - | - |
C-reactive protein, mg/L | ||||
≤110 | 1 (ref) | |||
>110 | 0.76 (0.35–1.62) | 0.46 | - | - |
Procalcitonin, ng/mL | ||||
≤0.36 | 1 (ref) | 1 (ref) | ||
>0.36 | 0.51 (0.21–1.23) | 0.11 | 0.71 (0.13–1.49) | 0.22 |
Radiographic findings | ||||
Bilateral pulmonary infiltration (vs. other) | 2.33 (1.12–4.85) | 0.02 | 2.41 (1.09–5.69) | 0.04 |
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Poletto, F.; Spiezia, L.; Simion, C.; Campello, E.; Dalla Valle, F.; Tormene, D.; Camporese, G.; Simioni, P. Risk Factors of Venous Thromboembolism in Noncritically Ill Patients Hospitalized for Acute COVID-19 Pneumonia Receiving Prophylactic-Dose Anticoagulation. Viruses 2022, 14, 737. https://doi.org/10.3390/v14040737
Poletto F, Spiezia L, Simion C, Campello E, Dalla Valle F, Tormene D, Camporese G, Simioni P. Risk Factors of Venous Thromboembolism in Noncritically Ill Patients Hospitalized for Acute COVID-19 Pneumonia Receiving Prophylactic-Dose Anticoagulation. Viruses. 2022; 14(4):737. https://doi.org/10.3390/v14040737
Chicago/Turabian StylePoletto, Francesco, Luca Spiezia, Chiara Simion, Elena Campello, Fabio Dalla Valle, Daniela Tormene, Giuseppe Camporese, and Paolo Simioni. 2022. "Risk Factors of Venous Thromboembolism in Noncritically Ill Patients Hospitalized for Acute COVID-19 Pneumonia Receiving Prophylactic-Dose Anticoagulation" Viruses 14, no. 4: 737. https://doi.org/10.3390/v14040737
APA StylePoletto, F., Spiezia, L., Simion, C., Campello, E., Dalla Valle, F., Tormene, D., Camporese, G., & Simioni, P. (2022). Risk Factors of Venous Thromboembolism in Noncritically Ill Patients Hospitalized for Acute COVID-19 Pneumonia Receiving Prophylactic-Dose Anticoagulation. Viruses, 14(4), 737. https://doi.org/10.3390/v14040737