Does COVID-19 infection increase the risk of pulmonary embolism in ambulatory patients with deep vein thrombosis

Objectives Coronavirus disease 2019 (COVID-19) can lead to systemic coagulation activation and thrombotic complications including venous thromboembolism. This study compares the development of pulmonary embolism, post-thrombotic syndrome, and clinical outcomes of COVID-19 and non-COVID-19 patients with deep vein thrombosis (DVT). Methods One hundred and eight patients diagnosed with acute deep vein thrombosis (DVT) between June 2020 and February 2021 in our institution were included in this retrospective study. Thirty-nine patients had been previously diagnosed with COVID-19 and specified as the COVID-19 group. Sixty-nine patients did not have COVID-19 and specified as the non-COVID-19 group. Mean ages of both groups were 64.3 ± 15.8 and 60.1 ± 19.7 years, respectively ( p = .37). Results The median duration from the onset of the COVID-19 to diagnosis of DVT was 22 (2–120) days in the COVID-19 group. The patients of two groups were mostly treated outpatient at rates of 94.9% vs 94.2%, respectively ( p = .88). Pulmonary embolism was seen in six patients (15.4%) in the COVID-19 group and in three patients (4.3%) in the non-COVID-19 group ( p = .04). Kaplan–Meir curves showed that patients with COVİD-19 had significantly higher pulmonary embolism than those without COVID-19 ( p = .015). The recurrence rate of DVT was 2.6% in the COVID-19 group ( n = 1), and 4.3% in the non-COVID-19 group ( n = 3), indicating no statistically significant difference ( p = .63). Mortality was seen in six patients (15.4%) in the COVİD-19 group, and in seven patients (10.1%) in the non-COVID-19 group. According to the Kaplan–Meir method, 10 months survival rates were 73.9 ± 10% in the COVID-19 group, and 66.3 ± 12.8% in the non-COVID-19 group with no statistical significance ( p = .218). Conclusions Our data draw attention to the fact that deep vein thrombosis should not be considered a safe and self-limited condition. Efficient preventive measures such as mobilization and prophylactic drug use should be considered to prevent DVT during the management of COVID-19.

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P6461The long-term clinical comparisons of symptomatic patients of pulmonary embolism with and those without deep vein thrombosis: from the COMMAND VTE Registry

European Heart Journal ◽

10.1093/eurheartj/ehz746.1053 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Murata ◽

Y Yamashita ◽

T Morimoto ◽

H Amano ◽

T Takase ◽

...

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Acute Phase ◽

Clinical Presentation ◽

Vein Thrombosis ◽

Significant Difference ◽

Severe Clinical Presentation ◽

Recurrent Vte ◽

Deep Vein

Abstract Background Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), has significant morbidity and mortality. Acute PE, in particular, is fatal if we miss it, and symptomatic patients of PE sometimes have concomitant DVT. Purpose This study compared the risk of mortality in symptomatic patients of PE with and those without DVT in the long term. Methods The COMMAND VTE Registry is a multicenter registry enrolling consecutive 3027 patients with acute symptomatic VTE objectively confirmed by imaging examination or by autopsy among 29 centers in Japan between January 2010 and August 2014. Patients with both PE and DVT (N=1334) were regarded as PE patients, and the current study population consisted of 1715 PE patients and 1312 DVT patients. Results There were 1203 symptomatic patients of PE, including 381 without and 822 with DVT. In our cohort, the mean age was 67.9±14.9 years, 63% was female, 44% had hypertension, 12% diabetes mellitus, 5% history of VTE. There were 20% of active cancer. Baseline characteristics were well matched except for dyslipidemia (18% vs. 23%, p=0.021) and atrial fibrillation (8% vs. 5%, p=0.045). Patients without DVT had a more severe clinical presentation compared to those with DVT, including hypoxemia, shock and arrest. Moreover, Initial parenteral anticoagulation therapy in the acute phase was administered less frequently in patients without DVT (89% vs. 96%, P=0.0001). Two groups received thrombolysis (20% vs. 26%, P=0.18) and mechanical supports (Ventilator 14% vs. 5%, p<0.001, PCPS 5% vs. 3%, p<0.001, respectively). During follow-up, 93 (8%) patients experienced recurrent VTE events and 98 (8%) major bleeding events, and 323 (27%) patients died. The most frequent cause of death was cancer (11%). There were a significant differences in the cumulative incidences of all-cause death between the groups (32% vs. 24%, P=0.006), whereas there was significant difference in VTE-related death (13% vs. 4%, p<0.001). Estimated freedom rates from death for patients of PE without and those with DVT were as follows: 88% vs 99% at 10-day, 86% vs 95% at 1-month, 75% vs 83% at 1-year, and 64% vs 71% at 5-year, respectively. Landmark analysis Conclusions In symptomatic patients of PE, there was a difference in mortality between groups, but no difference in recurrent VTE. Patients without DVT had a more severe clinical presentation compared to those with DVT, and many VTE-related deaths in the acute phase. The one-month mortality rate differed statistically between groups, but there was no significant difference in long-term survival beyond one month. Most of deaths were due to underlying diseases, mainly cancer, and less commonly due to VTE in the long term. Acknowledgement/Funding Research Institute for Production Development, Mitsubishi Tanabe Pharma Corporation

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Thromboembolic Disease in COVID-19

Journal of Clinical Imaging Science ◽

10.25259/jcis_108_2020 ◽

2021 ◽

Vol 11 ◽

pp. 16

Author(s):

Tara Tarmey ◽

Grace Cullen ◽

Tanay Y. Patel ◽

Yasmeen Kour Tandon

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Clinical Manifestations ◽

Thromboembolic Disease ◽

Morbidity And Mortality ◽

Respiratory Dysfunction ◽

Vein Thrombosis ◽

Thrombotic Complications ◽

Deep Vein

Coronavirus disease 2019 (COVID-19) was initially recognized in late December 2019 and has quickly spread globally with over 114 million reported cases worldwide at the time of this publication. For the majority of patients infected with COVID-19, the clinical manifestations are absent or mild. In more advanced cases, severe respiratory dysfunction is the leading cause of morbidity and mortality. However, increasingly, there have been reports of increased thrombotic complications including pulmonary embolism and deep vein thrombosis seen in these patients. We present herein a series of cases of concomitant COVID-19 pneumonia and venous thromboembolism. These cases highlight the importance of clinical and radiologic vigilance to ensure this often clinically silent complication is not missed.

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Differences in Clinical Presentation, Rate of Pulmonary Embolism, and Risk Factors Among Patients With Deep Vein Thrombosis in Unusual Sites

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619872550 ◽

2019 ◽

Vol 25 ◽

pp. 107602961987255 ◽

Cited By ~ 2

Author(s):

Angelo Porfidia ◽

Enrica Porceddu ◽

Daniela Feliciani ◽

Marzia Giordano ◽

Fabiana Agostini ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

University Hospital ◽

Cerebral Vein ◽

Jugular Vein Thrombosis ◽

Unusual Site ◽

Vein Thrombosis ◽

Significant Difference ◽

Deep Vein

Unusual site deep vein thrombosis (USDVT) is an uncommon form of venous thromboembolism with heterogeneous signs and symptoms, unknown rate of pulmonary embolism (PE), and poorly defined risk factors. We conducted a retrospective analysis of 107 consecutive cases of USDVTs, discharged from our University Hospital over a period of 2 years. Patients were classified based on the site of thrombosis and distinguished between patients with cerebral vein thrombosis, jugular vein thrombosis, thrombosis of the deep veins of the upper extremities, and abdominal vein thrombosis. We found statistically significant differences between groups in terms of age ( P < .0001) and gender distribution ( P < .05). We also found that the rate of symptomatic patients was significantly different between groups ( P < .0001). Another interesting finding was the significant difference between groups in terms of rate of PE ( P < .01). Finally, we found statistically significant differences between groups in terms of risk factors for thrombosis, in particular cancer ( P < .01). Unprovoked cases were differently distributed among groups ( P < .0001). This study highlights differences between patients with USDVT, which depend on the site of thrombosis, and provides data which might be useful in clinical practice.

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Increased deep vein thrombosis cases during the COVID-19 quarantine

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520977294 ◽

2020 ◽

pp. 026835552097729

Author(s):

Evren Karaali ◽

Osman Çiloğlu ◽

Orhan Saim Demirtürk ◽

Burak Keklikçioğlu ◽

İsmail Akçay ◽

...

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Hospital Admissions ◽

Previous History ◽

Vein Thrombosis ◽

Symptomatic Pulmonary Embolism ◽

Number Of Patients ◽

Prophylactic Drug ◽

History Of ◽

Deep Vein

Objective The aim of this study was to compare the number of deep vein thrombosis (DVT) cases during the quarantine period for COVID-19 to that of the last year. Methods This study was conducted as a single-center and retrospective study. All hospital admissions during April 2020 and May 2020 were screened from the hospital records, and DVT cases were recorded. Likewise, all hospital admissions during April 2019 and May 2019 were screened, and DVT cases were noted. DVT cases of both years were compared. Results Among 480931 patients admitted to our hospital in April 2019 and May 2019, DVT was detected in 82 patients (0.017%) (47 males, 35 females) with a mean age of 56.99 ± 9.1 years (ranges 39 to 79 years). Besides, among 145101 patients admitted to our hospital in April 2020 and May 2020, DVT was detected in 123 patients (0.084%) (51 males, 72 females) with a mean age of 58.64 ± 8.9 years (ranges 40 to 83 years). Despite the decrease in the total number of patients admitted to the hospital, there was a significant increase in the number of DVT patients. Interestingly, there were only two symptomatic pulmonary-embolism cases in the 2019 period, whereas there were seven symptomatic pulmonary embolisms secondary to DVT in the 2020 period. Unfortunately, one patient died due to pulmonary embolism secondary to DVT in 2020. The previous history of DVT was remarkable in patients admitted during the COVID-19 confinement. Conclusion In conclusion, COVID-19 confinement seems to be associated with increased rates of DVT. Strict preventive measures such as exercise training or prophylactic drug use should be considered to prevent immobility-related DVT during the COVID-19 quarantine.

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Venous Thromboembolism Within Professional American Sport Leagues

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117745530 ◽

2017 ◽

Vol 5 (12) ◽

pp. 232596711774553 ◽

Cited By ~ 8

Author(s):

Meghan Bishop ◽

Matthew Astolfi ◽

Eric Padegimas ◽

Peter DeLuca ◽

Sommer Hammoud

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Lower Extremity ◽

Upper Extremity ◽

Return To Play ◽

Professional Athletes ◽

Vein Thrombosis ◽

Significant Difference ◽

Deep Vein

Background: Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes. Purpose: To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes. Study Design: Descriptive epidemiology study. Methods: An online search of all team injury and media reports of DVT/PE in NHL, MLB, NBA, and NFL players available for public record was conducted by use of Google, PubMed, and SPORTDiscus. Searches were conducted using the professional team name combined with blood clot, pulmonary embolism, and deep vein thrombosis. Results: A total of 55 venous thromboembolism (VTE) events were identified from 1999 through 2016 (NHL, n = 22; MLB, n = 16; NFL, n = 12; NBA, n = 5). Nineteen athletes were reported to have an upper extremity DVT, 15 had a lower extremity DVT, 15 had a PE, and 6 had DVT with PE. Six athletes sustained more than 1 VTE. The mean age at time of VTE was 29.3 years (range, 19-42 years). Mean (±SD) time lost from play was 6.7 ± 4.9 months (range, 3 days to career end). Seven athletes did not return to play. Players with upper extremity DVT had a faster return to play (mean ± SD, 4.3 ± 2.7 months) than those with lower extremity DVT (5.9 ± 3.8 months), PE (10.8 ± 6.8 months), or DVT with PE (8.2 ± 2.6 months) ( F = 5.69, P = .002). No significant difference was found regarding time of return to play between sports. Conclusion: VTE in professional athletes led to an average of 6.7 months lost from play. The majority of athletes were able to return to play after a period of anticoagulation or surgery. Those with an upper extremity DVT returned to play faster than those with other types of VTE. Further study is needed to look into modifiable risk factors for these events and to establish treatment and return-to-play guidelines to ensure the safety of these athletes.

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Deep Vein Thrombosis and Pulmonary Embolism in the Setting of Mycoplasma Infection

Case Reports in Medicine ◽

10.1155/2020/8708417 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Sandal Saleem ◽

Brian Berman

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Mycoplasma Pneumoniae ◽

Comprehensive Evaluation ◽

Anticoagulation Therapy ◽

Pulmonary Emboli ◽

Mycoplasma Infection ◽

Vein Thrombosis ◽

Thrombotic Complications ◽

Deep Vein

Thirteen-year-old female twins presented one week apart with documented Mycoplasma pneumoniae respiratory infection. Each developed venous thrombosis and pulmonary emboli in association with transient self-limited para-infectious anti-phospholipid antibodies. Comprehensive evaluation revealed no identifiable genetic prothrombotic variables. Both children recovered after receiving antibiotics and anticoagulation therapy. Thrombotic complications associated with Mycoplasma pneumoniae infections are rare, particularly in children; the occurrence of this complication in identical twins has not been previously reported.

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Deep vein thrombosis and pulmonary embolism in pediatric COVID-19

10.22541/au.163265310.03774825/v1 ◽

2021 ◽

Author(s):

Loukia Ioannidou ◽

Athina Dettoraki ◽

Maria Noni ◽

Dimitra Koukou ◽

Aiketarini Michalopoulou ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Laboratory Tests ◽

Rt Pcr ◽

Aromatase Inhibitor Therapy ◽

Vein Thrombosis ◽

Prothrombotic Risk Factors ◽

Thrombotic Complications ◽

Deep Vein

Thrombotic complications of SARS-CoV-2 have been increasingly recognized as an important component of COVID-19 in adults; however, they have been less evident in children. We report a case of a teenager with positive SARS‐CoV‐2 RT–PCR and underlying prothrombotic risk factors, including aromatase inhibitor therapy, who developed deep vein thrombosis resulting in pulmonary embolism. Laboratory tests revealed deranged coagulation parameters (high D-dimers and Factor VIII and low antithrombin). The patient required intensive care and was managed with anticoagulants, dexamethasone and antithrombin concentrate. Clinical condition and hemostatic profile gradually improved. A review of the available literature for similar cases is presented.

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