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DVT and Pulmonary Embolism in Covid-19 patients

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    By Katherine Kozlowski, Associate Editor for Vein News and VeinVeinsVeins.com 

    A recent study looked at the association of pulmonary embolism (PE) with deep vein thrombosis (DVT) in patients with coronavirus disease 2019 (COVID-19) and the diagnostic accuracy of D-dimer tests for PE.

    Study Aim

    The purpose of the study was to  determne the incidence of PE and DVT and to evaluate the diagnostic accuracy of D-dimer tests for PE from multicenter individual patient data.

    Materials and Methods:

    The authors (see below reference) did a systematic literature search identified studies evaluating the incidence of PE or DVT in patients with COVID-19 from January 1, 2020, to June 15, 2020.

    The authors pooled outcomes from these studies using a random-effects model and evaluated them using metaregression analysis.

    The diagnostic accuracy of D-dimer tests for PE was estimated on the basis of individual patient data.

    Results of the study: 

    Twenty-seven studies with 3342 patients with COVID-19 were included in the analysis.

    The pooled incidence rates of PE and DVT were 16.5% (95% CI: 11.6, 22.9; 
    I2 = 0.93) and 14.8% (95% CI: 8.5, 24.5; I2 = 0.94), respectively.

    PE was more frequently found in patients who were admitted to the intensive care unit (ICU) (24.7% [95% CI: 18.6, 32.1] vs 10.5% [95% CI: 5.1, 20.2] in those not admitted to the ICU) and in studies with universal screening using CT pulmonary angiography.

    DVT was present in 42.4% of patients with PE.

    D-dimer levels of 500 and 1000 μg/L showed high sensitivity (96% and 91%, respectively) but low specificity (10% and 24%, respectively).

    Study Conclusions

    The authors of this study concluded that Pulmonary embolism (PE) and deep vein thrombosis (DVT) occurred in 16.5% and 14.8% of patients with coronavirus disease 2019 (COVID-19).

    More than half of patients with PE lacked DVT.

    The cutoffs of D-dimer levels used to exclude PE in preexisting guidelines seem applicable to patients with COVID-19. 


    Reference:  Suh YJ, Hong H, Ohana M, Bompard F, Revel MP, Valle C, Gervaise A, Poissy J, Susen S, Hékimian G, Artifoni M, Periard D, Contou D, Delaloye J, Sanchez B, Fang C, Garzillo G, Robbie H, Yoon SH.  Pulmonary embolism and deep vein thrombosis in Covid-19:  A systematic review and meta analysis.  Radiology 2021; 298: E70-E80.