Abstract Number: PB0261
Meeting: ISTH 2021 Congress
Background: It is widely reported that patients infected with severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) are at increased risk of developing venous thromboembolic disease (VTD) requiring prophylactic heparin.
Aims: To describe predictive biomarkers at the time of emergency room (ER) admission that could predict the development of VTD in these patients.
Methods: From March 2020 to April 2020, 105 patients with COVID-19 were included in this retrospective study. Demographic characteristics, clinical history and blood test data at time of ER admission were collected. Data were compared using Mann–Whitney U test for continuous variables and Chi-squared test for categorical variables. Univariate and multivariate logistic regression analysis were performed to identify independent impact on VTD risk.
Results: Forty-seven patients (44%) presented thromboembolic event (group 1). Thirty-four (32%) of them developed VTD during hospitalization while 13 patients (12%) presented it at the time of ER admission. Blood test results at the time of ER admission are shown in Table 1.
|Group 1 (N: 47)||Group 2 (N: 58)||p-value|
|D-dimer (ng/dl)||3613 (96-32967)||2448 (95-50354)||0.007|
|Platelet count (cell/µL)||214000 (46000-554000)||216000 (21000-519000)||0.97|
|Lymphocyte count (cell/µL)||859 (200-1800)||998 (200-3100)||0.47|
|International Normalized Ratio||1.1 (0.3-1.62)||1.27 (0.95-5.57)||0.38|
|Fibrinogen (mg/dl)||716 (440-949)||741 (232-1000)||0.44|
|Creatinine (mg/dl)||1.03 (0.52-2.07)||0.92 (0.49-1.48)||0.072|
|Oxygen saturation level (%)||86% (55-98)||92% (76-99)||0.002|
|Length of stay (days)||32 (5-119)||16 (2-71)||0.001|
Statistical differences between both groups were not significant in terms of personal background data collected: age, gender, cardiovascular risk factors, VTD risk factors (obesity, smoking, active cancer, previous immobilization, recent surgical intervention, former VTD or hormone therapy) and previous anticoagulant treatment. In group 1, 17 patients (36%) required ICU admission vs 11 patients (19%) in group 2 (p = 0.047).
Representative univariate and multivariate regression analysis are shown in Table 2. High D-dimer levels and low oxygen saturation levels were discovered to be independent predictors of VTD. In ROC curve analysis, D-dimer levels above 500 ng/dl detects VTD development with a sensitivity of 71.9% and a specificity of 58.6% (AUC: 0.672).
|D-dimer > 500ng/dl||3.620||0.007||6.734||0.013|
|D-dimer > 1000ng/dl||5.444||0.001|
|Oxygen saturation level < 95%||6.289||0.002||11.650||0.002|
|Oxygen saturation level < 90%||2,262||0.078|
|High flow oxygen therapy||3.258||0.005||2.831||0.137|
Conclusions: In our study, higher D-dimer values and lower oxygen saturation levels at the time of ER admission seems to be predictors of development of VTD during hospitalization in patients with Sars-Cov2 infection.
To cite this abstract in AMA style:Silva de Tena P, Gómez de Antonio R, Martín Rojas RM, Perez Rus G, Díez-Martín JL, Pascual Izquierdo C. Venous Thromboembolic Disease in Patients Wwith SARS-CoV2 Infection: In Search of a Predictive Biomarker [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/venous-thromboembolic-disease-in-patients-wwith-sars-cov2-infection-in-search-of-a-predictive-biomarker/. Accessed December 3, 2021.
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