A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19
Background. Recent studies have shown an increased prevalence of thromboembolic disease in critically ill patients with the novel SARS-CoV-2 disease (COVID-19). However, the use of enhanced anticoagulation therapy in these patients remains controversial. Objectives. To determine the incidence of thr...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/8737580 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832564498018336768 |
|---|---|
| author | Fahad Faqihi Abdulrahman Alharthy Abdullah Balhamar Nasir Nasim Khaled Alanezi Feisal Alaklobi Ziad A. Memish Mike Blaivas Saleh A. Alqahtani Dimitrios Karakitsos |
| author_facet | Fahad Faqihi Abdulrahman Alharthy Abdullah Balhamar Nasir Nasim Khaled Alanezi Feisal Alaklobi Ziad A. Memish Mike Blaivas Saleh A. Alqahtani Dimitrios Karakitsos |
| author_sort | Fahad Faqihi |
| collection | DOAJ |
| description | Background. Recent studies have shown an increased prevalence of thromboembolic disease in critically ill patients with the novel SARS-CoV-2 disease (COVID-19). However, the use of enhanced anticoagulation therapy in these patients remains controversial. Objectives. To determine the incidence of thromboembolic phenomena (TEP) and hemorrhagic events (HEs) in intensive care unit (ICU) COVID-19 patients. Methods. One hundred and sixty ICU patients with COVID-19 were enrolled. Clinical examination results, laboratory data, and imaging studies (computed tomography/Doppler ultrasound scans) for these patients were retrospectively collected and analyzed. Outcome measures including days on mechanical ventilation, ICU length of stay, and day-28 mortality were recorded. Results. Sixty patients (37.5%) developed TEP including thirty patients with deep vein thrombosis, 55 patients with pulmonary embolism, and 7 patients with arterial thromboembolism. Cardiac arrhythmias, lymphocytopenia, and increased D-dimers were more frequently observed in the TEP group compared to the non-TEP group of patients (all p<0.05). The sensitivity, specificity, and positive and negative predictive values of a cutoff D-dimer level of 3.0 μg/mL for predicting PE were 74.5%, 95.1%, 86.8%, and 91.9%, respectively. Thirteen patients experienced HEs, which were more frequently observed in the TEP group (p<0.05). Twenty-eight-day mortality was higher in the TEP group (60%) compared to the non-TEP group (30%) of patients (p=0.02). Conclusions. The rates of TEP and HEs in mechanically ventilated critically ill COVID-19 patients were 37. 5% and 8.1%. Twenty-eight-day mortality was higher in the TEP group (60%) compared to the non-TEP group (30%) of patients. |
| format | Article |
| id | doaj-art-b2c8b862af874e4d99f17b1f449086d3 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-b2c8b862af874e4d99f17b1f449086d32025-02-03T01:10:53ZengWileyCritical Care Research and Practice2090-13052090-13132021-01-01202110.1155/2021/87375808737580A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19Fahad Faqihi0Abdulrahman Alharthy1Abdullah Balhamar2Nasir Nasim3Khaled Alanezi4Feisal Alaklobi5Ziad A. Memish6Mike Blaivas7Saleh A. Alqahtani8Dimitrios Karakitsos9Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaCritical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaCritical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaCritical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaKing Saud Medical City, Riyadh, Saudi ArabiaKing Saud Medical City, Riyadh, Saudi ArabiaResearch and Innovation Center, King Saud Medical City, Riyadh, Saudi ArabiaDepartment of Internal Medicine, University of South Carolina, School of Medicine, Columbia, SC, USATransplant Hepatology Division of Gastroenterology and Hepatology, Johns Hopkins University, School of Medicine, Baltimore, MD, USACritical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaBackground. Recent studies have shown an increased prevalence of thromboembolic disease in critically ill patients with the novel SARS-CoV-2 disease (COVID-19). However, the use of enhanced anticoagulation therapy in these patients remains controversial. Objectives. To determine the incidence of thromboembolic phenomena (TEP) and hemorrhagic events (HEs) in intensive care unit (ICU) COVID-19 patients. Methods. One hundred and sixty ICU patients with COVID-19 were enrolled. Clinical examination results, laboratory data, and imaging studies (computed tomography/Doppler ultrasound scans) for these patients were retrospectively collected and analyzed. Outcome measures including days on mechanical ventilation, ICU length of stay, and day-28 mortality were recorded. Results. Sixty patients (37.5%) developed TEP including thirty patients with deep vein thrombosis, 55 patients with pulmonary embolism, and 7 patients with arterial thromboembolism. Cardiac arrhythmias, lymphocytopenia, and increased D-dimers were more frequently observed in the TEP group compared to the non-TEP group of patients (all p<0.05). The sensitivity, specificity, and positive and negative predictive values of a cutoff D-dimer level of 3.0 μg/mL for predicting PE were 74.5%, 95.1%, 86.8%, and 91.9%, respectively. Thirteen patients experienced HEs, which were more frequently observed in the TEP group (p<0.05). Twenty-eight-day mortality was higher in the TEP group (60%) compared to the non-TEP group (30%) of patients (p=0.02). Conclusions. The rates of TEP and HEs in mechanically ventilated critically ill COVID-19 patients were 37. 5% and 8.1%. Twenty-eight-day mortality was higher in the TEP group (60%) compared to the non-TEP group (30%) of patients.http://dx.doi.org/10.1155/2021/8737580 |
| spellingShingle | Fahad Faqihi Abdulrahman Alharthy Abdullah Balhamar Nasir Nasim Khaled Alanezi Feisal Alaklobi Ziad A. Memish Mike Blaivas Saleh A. Alqahtani Dimitrios Karakitsos A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19 Critical Care Research and Practice |
| title | A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19 |
| title_full | A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19 |
| title_fullStr | A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19 |
| title_full_unstemmed | A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19 |
| title_short | A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19 |
| title_sort | retrospective analysis of thromboembolic phenomena in mechanically ventilated patients with covid 19 |
| url | http://dx.doi.org/10.1155/2021/8737580 |
| work_keys_str_mv | AT fahadfaqihi aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT abdulrahmanalharthy aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT abdullahbalhamar aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT nasirnasim aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT khaledalanezi aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT feisalalaklobi aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT ziadamemish aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT mikeblaivas aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT salehaalqahtani aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT dimitrioskarakitsos aretrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT fahadfaqihi retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT abdulrahmanalharthy retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT abdullahbalhamar retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT nasirnasim retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT khaledalanezi retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT feisalalaklobi retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT ziadamemish retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT mikeblaivas retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT salehaalqahtani retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 AT dimitrioskarakitsos retrospectiveanalysisofthromboembolicphenomenainmechanicallyventilatedpatientswithcovid19 |