Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis

Background: A higher incidence of thrombotic events, mainly pulmonary embolism (PE), has been reported in hospitalized patients with COVID-19. The main objective was to assess clinical and laboratory differences in hospitalized COVID-19 patients according to occurrence of PE. Methods: This retrospec...

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Autores: Cerdà, Pau, Ribas, Jesús, Iriarte, Adriana, Mora Luján, José María, Torres, Raquel, Río, Belén del, Jofré, Héctor Ignacio, Ruiz, Yolanda, Huguet, Marta, Fuset, Maria Paz, Martínez Yélamos, Sergio, Santos, Salud, Llecha, Núria, Corbella, Xavier, Riera Mestre, Antoni
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/175619
Acceso en línea:https://hdl.handle.net/2445/175619
Access Level:acceso abierto
Palabra clave:COVID-19
Embòlia pulmonar
Anticoagulants (Medicina)
Tromboembolisme
Pulmonary embolism
Anticoagulants (Medicine)
Thromboembolism
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spelling Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosisCerdà, PauRibas, JesúsIriarte, AdrianaMora Luján, José MaríaTorres, RaquelRío, Belén delJofré, Héctor IgnacioRuiz, YolandaHuguet, MartaFuset, Maria PazMartínez Yélamos, SergioSantos, SaludLlecha, NúriaCorbella, XavierRiera Mestre, AntoniCOVID-19Embòlia pulmonarAnticoagulants (Medicina)TromboembolismeCOVID-19Pulmonary embolismAnticoagulants (Medicine)ThromboembolismBackground: A higher incidence of thrombotic events, mainly pulmonary embolism (PE), has been reported in hospitalized patients with COVID-19. The main objective was to assess clinical and laboratory differences in hospitalized COVID-19 patients according to occurrence of PE. Methods: This retrospective study included all consecutive patients hospitalized with COVID-19 who underwent a computed tomography (CT) angiography for PE clinical suspicion. Clinical data and median blood test results distributed into weekly periods from COVID-19 symptoms onset, were compared between PE and non-PE patients. Results: Ninety-two patients were included, 29 (32%) had PE. PE patients were younger (63.9 (SD 13.7) vs 69.9 (SD 12.5) years). Clinical symptoms and COVID-19 CT features were similar in both groups. PE was diagnosed after a mean of 20.0 (SD 8.6) days from the onset of COVID-19 symptoms. Corticosteroid boluses were more frequently used in PE patients (62% vs. 43%). No patients met ISTH DIC criteria. Any parameter was statistically significant or clinically relevant except for D-Dimer when comparing both groups. Median values [IQR] of D-dimer in PE vs non-PE patients were: week 2 (2010.7 [770.1-11208.9] vs 626.0 [374.0-2382.2]; p = 0.004); week 3 (3893.1 [1388.2-6694.0] vs 1184.4 [461.8-2447.8]; p = 0.003); and week 4 (2736.3 [1202.1-8514.1] vs 1129.1 [542.5-2834.6]; p = 0.01). Median fold-increase of D-dimer between week 1 and 2 differed between groups (6.64 [3.02-23.05] vs 1.57 [0.64-2.71], p = 0.003); ROC curve AUC was 0.879 (p = 0.003) with a sensitivity and specificity for PE of 86% and 80%, respectively. Conclusions: Among hospitalized COVID-19 patients, D-dimer levels are higher at weeks 2, 3 and 4 after COVID-19 symptom onset in patients who develop PE. This difference is more pronounced when the fold increase between weeks 1 and 2 is compared.Public Library of Science (PLoS)2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/175619Articles publicats en revistes (Ciències Clíniques)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0243533PLoS One, 2020, vol. 15, num. 12, p. e0243533https://doi.org/10.1371/journal.pone.0243533cc-by (c) Cerdà, Pau et al., 2020http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1756192026-05-27T06:46:51Z
dc.title.none.fl_str_mv Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
title Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
spellingShingle Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
Cerdà, Pau
COVID-19
Embòlia pulmonar
Anticoagulants (Medicina)
Tromboembolisme
COVID-19
Pulmonary embolism
Anticoagulants (Medicine)
Thromboembolism
title_short Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
title_full Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
title_fullStr Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
title_full_unstemmed Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
title_sort Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
dc.creator.none.fl_str_mv Cerdà, Pau
Ribas, Jesús
Iriarte, Adriana
Mora Luján, José María
Torres, Raquel
Río, Belén del
Jofré, Héctor Ignacio
Ruiz, Yolanda
Huguet, Marta
Fuset, Maria Paz
Martínez Yélamos, Sergio
Santos, Salud
Llecha, Núria
Corbella, Xavier
Riera Mestre, Antoni
author Cerdà, Pau
author_facet Cerdà, Pau
Ribas, Jesús
Iriarte, Adriana
Mora Luján, José María
Torres, Raquel
Río, Belén del
Jofré, Héctor Ignacio
Ruiz, Yolanda
Huguet, Marta
Fuset, Maria Paz
Martínez Yélamos, Sergio
Santos, Salud
Llecha, Núria
Corbella, Xavier
Riera Mestre, Antoni
author_role author
author2 Ribas, Jesús
Iriarte, Adriana
Mora Luján, José María
Torres, Raquel
Río, Belén del
Jofré, Héctor Ignacio
Ruiz, Yolanda
Huguet, Marta
Fuset, Maria Paz
Martínez Yélamos, Sergio
Santos, Salud
Llecha, Núria
Corbella, Xavier
Riera Mestre, Antoni
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Embòlia pulmonar
Anticoagulants (Medicina)
Tromboembolisme
COVID-19
Pulmonary embolism
Anticoagulants (Medicine)
Thromboembolism
topic COVID-19
Embòlia pulmonar
Anticoagulants (Medicina)
Tromboembolisme
COVID-19
Pulmonary embolism
Anticoagulants (Medicine)
Thromboembolism
description Background: A higher incidence of thrombotic events, mainly pulmonary embolism (PE), has been reported in hospitalized patients with COVID-19. The main objective was to assess clinical and laboratory differences in hospitalized COVID-19 patients according to occurrence of PE. Methods: This retrospective study included all consecutive patients hospitalized with COVID-19 who underwent a computed tomography (CT) angiography for PE clinical suspicion. Clinical data and median blood test results distributed into weekly periods from COVID-19 symptoms onset, were compared between PE and non-PE patients. Results: Ninety-two patients were included, 29 (32%) had PE. PE patients were younger (63.9 (SD 13.7) vs 69.9 (SD 12.5) years). Clinical symptoms and COVID-19 CT features were similar in both groups. PE was diagnosed after a mean of 20.0 (SD 8.6) days from the onset of COVID-19 symptoms. Corticosteroid boluses were more frequently used in PE patients (62% vs. 43%). No patients met ISTH DIC criteria. Any parameter was statistically significant or clinically relevant except for D-Dimer when comparing both groups. Median values [IQR] of D-dimer in PE vs non-PE patients were: week 2 (2010.7 [770.1-11208.9] vs 626.0 [374.0-2382.2]; p = 0.004); week 3 (3893.1 [1388.2-6694.0] vs 1184.4 [461.8-2447.8]; p = 0.003); and week 4 (2736.3 [1202.1-8514.1] vs 1129.1 [542.5-2834.6]; p = 0.01). Median fold-increase of D-dimer between week 1 and 2 differed between groups (6.64 [3.02-23.05] vs 1.57 [0.64-2.71], p = 0.003); ROC curve AUC was 0.879 (p = 0.003) with a sensitivity and specificity for PE of 86% and 80%, respectively. Conclusions: Among hospitalized COVID-19 patients, D-dimer levels are higher at weeks 2, 3 and 4 after COVID-19 symptom onset in patients who develop PE. This difference is more pronounced when the fold increase between weeks 1 and 2 is compared.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/175619
url https://hdl.handle.net/2445/175619
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0243533
PLoS One, 2020, vol. 15, num. 12, p. e0243533
https://doi.org/10.1371/journal.pone.0243533
dc.rights.none.fl_str_mv cc-by (c) Cerdà, Pau et al., 2020
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Cerdà, Pau et al., 2020
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300719

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