Rate of venous thromboembolism in a prospective all-comers cohort with COVID-19
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Rate of venous thromboembolism in a prospective all‑comers cohort with COVID‑19 Marina Rieder1,2 · Isabella Goller1,2 · Maren Jeserich1,2 · Niklas Baldus1,2 · Luisa Pollmeier4 · Luisa Wirth4 · Alexander Supady1,2 · Christoph Bode1,2 · Hans‑Jörg Busch3 · Bonaventura Schmid3 · Daniel Duerschmied1,2 · Nadine Gauchel1,2 · Achim Lother1,2,4
© The Author(s) 2020
Abstract COVID-19 is associated with a variety of clinical complications including coagulopathy, which frequently results in venous thromboembolism (VTE). Retrospective analyses reported a markedly increased rate of VTEs in COVID-19. However, most recent studies on coagulopathy in COVID-19 were only focused on critically ill patients, and without suitable control groups. We aimed to evaluate the rate of VTEs in an all-comers cohort with suspected COVID-19 during a 30-days follow-up period. We also studied the level of D-dimers and their association with the course of disease. In our prospective single-center study (DRKS00021206, 03/30/2020), we analyzed 190 patients with suspected COVID-19 admitted to the emergency department between March and April 2020. Forty-nine patients were SARS-CoV-2 positive (25.8%). The 141 SARS-CoV-2-negative patients served as control group. After completion of a 30-days follow-up, VTE was diagnosed in 3 patients of the SARSCoV-2-positive group (6.1%, amongst these 2 ICU cases) versus 5 patients in the SARS-CoV-2-negative group (3.5%), however the difference was not statistically significant (p = 0.427). 30-days mortality was similar in both groups (6.1% vs. 5%, p = 0.720). Disease severity correlated with the maximum level of D-dimers during follow-up in COVID-19. The rate of VTE was numerically higher in SARS-CoV-2 positive all-comers presenting with suspected COVID-19 as compared to well-matched controls suffering from similar symptoms. VTEs in the COVID-19 group predominantly occurred in ICU courses. The maximum level of D-dimers during follow-up was associated with disease severity in COVID-19, whereas the level of D-dimers at admission was not. Keywords COVID-19 · D-dimers · SARS-CoV-2 · Venous thromboembolism
Highlights Nadine Gauchel and Achim Lother have contributed equally to this work. * Marina Rieder marina.baeuml@universitaets‑herzzentrum.de 1
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
2
Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
3
Department of Emergency Medicine, Faculty of Medicine, University Hospital of Freiburg, University of Freiburg, Freiburg, Germany
4
Institute of Experimental and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
• Previous studies reported an increased incidence of VTEs
in COVID-19.
• These previous studies were mostly retrospective,
focused on critically ill patients and did not include suitable control groups. • In our prospect
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