Hospitalized COVID-19 Patients and Venous Thromboembolism
Notice bibliographique
Résumé
he coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 has taken the world by storm.As of May 4, 2020, there are >1.2 million confirmed cases in the United States and >66 000 deaths.Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is common in seriously ill patients with infection.Early reports suggested a VTE rate of approximately 27% in critically ill patients hospitalized with This high rate of VTE, and, in particular, PE, is consistent with what has been reported in critically ill patients with pneumonias caused by other viruses, including H1N1 pneumonia and severe acute respiratory syndrome.2,3 Key markers of inflammation and coagulopathy have been associated with morbidity and increased mortality in hospitalized patients with COVID-19, suggesting that either the severe acute respiratory syndrome coronavirus 2 infection itself or the cytokine storm produced by the hyperinflammatory state induces a prothrombotic state. 4COVID-19 is associated with a coagulopathy characterized by mild thrombocytopenia, high levels of d-dimer and fibrin(ogen) degradation products, slight prolongation of the prothrombin time, and elevated levels of fibrinogen and factor VIII. [4][5][6] Although the drivers of this coagulopathy are uncertain, overexpression of tissue factor, endothelial dysfunction, and activation of the contact and complement systems are potential candidates.In patients dying of COVID-19, multiple thrombi are found in the vessels of the lungs, and those of the liver, heart, and kidneys.This hypercoagulable state may explain the high rate of VTE reported in patients with COVID-19 despite anticoagulant thromboprophylaxis, 1 and the acute kidney injury, myocardial infarction, ischemic stroke, and arterial occlusion, as well, that have been described in these patients.6,7 In this issue of Circulation, case series of hospitalized patients with COVID-19 reported from China by Zhang et al 8 and Ren et al 9 and from France by Poissy et al 10 highlight the high prevalence of VTE in this population.Consistent with earlier reports of high VTE rates in critically ill patients with COVID-19, the prevalence of PE in 107 consecutive patients in the intensive care unit was 20.6% in the study by Poissy et al. 10 Of the 22 patients with documented PE, 20 were receiving anticoagulant thromboprophylaxis at the time of PE diagnosis.When 48 patients in an intensive care unit with documented COVID-19 were screened with compression ultrasonography of the lower extremities, Ren et al 9 reported a prevalence of asymptomatic DVT of 85.4%, with 75% localized to the calf veins.In the patients with DVT, all but 1 were receiving low-molecular-weight heparin thromboprophylaxis.Likewise, with compression ultrasound screening of 143 hospitalized patients with COVID-19 on medical wards, Zhang et al 8 found DVT in 46.1% overall, of which the location is
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».