D-dimer Unreliable for Ruling Out PE in COVID-19 D-dimer Unreliable for Ruling Out PE in COVID-19
Plasma d-dimer levels to rule out pulmonary embolism in hospitalized COVID-19 patients is not the right assay to use, new research suggests. Most patients already have levels greater than 0.05 μg/mL.Medscape Medical News
Acta Med Port. 2021 Nov 26. doi: 10.20344/amp.17016. Online ahead of print.ABSTRACTINTRODUCTION: Risk factors comprising the CHA2DS2VASc score are recognized as risk factors for venous thromboembolism and mortality in COVID-19 patients. A modified CHA2DS2VASc score (M-CHA2D2VASc), developed by changing gender criteria from female to male, has been proposed to predict in-hospital mortality in COVID-19 patients. The aim of this study was to evaluate the prognostic accuracy of M-CHA2D2VASc for adverse clinical outcomes and short-term mortality in COVID-19 patients admitted to the Emergency Department.MATERIAL AND METHODS: Ret...
One and a half years after the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the high morbidity and mortality across the world is still a concern. To date, more than 255 million confirmed cases have been reported, including more than 5.1 million deaths (WHO, 2021). An extenuating effort in research and clinical efforts led to improvements in diagnostic strategies and therapeutics, however data gathered by the World Health Organization (WHO) about the case fatality rate across the countries are threatening (Ioannidis, 2021).
Wien Klin Wochenschr. 2021 Nov 25:1-8. doi: 10.1007/s00508-021-01973-1. Online ahead of print.ABSTRACTHigh incidence of venous thromboembolic (VTE) events in coronavirus disease 2019 (COVID-19) patients has been reported despite pharmacologic thromboprophylaxis. We performed prospective bilateral lower extremity ultrasound evaluation of prolonged hospitalized COVID-19 ward patients from our institution without clinical suspicion of deep vein thrombosis (DVT).A total of 102 patient were included in the study. All patients were receiving pharmacologic thromboprophylaxis, the majority in intermediate or therapeutic doses. Asy...
Conclusions: This represents a first step towards a complete intelligent radiomic system to optimize PE diagnosis by Q-SPECT/CT and encourages the development of a tool in the cloud for clinical use.
Conclusion: Since all of these patients presented to our clinic as presumptive COVID patients, our series highlights the need of careful evaluation of patients with happy hypoxia for causes other than COVID-19.
Discussion: Cardiac abnormalities may exist post COVID-19 and predicting this is challenging. Patient-reported breathlessness and cardiac biomarkers may not be useful in predicting cardiac impairment.
Elevated D-dimer is known as predictor for severity of SARS-CoV2-infection. Thereby, elevated D-dimer is associated with thromboembolic complications, but it is also a direct consequence of the acute lung injury seen in COVID-19 pneumonia.To evaluate the rate of persistent elevated D-dimer and its association with thromboembolic complications and persistent ground glass opacities (GGO) after recovery from COVID-19.In this post hoc analysis of a prospective multicenter trial, patients underwent blood sampling, measurement of diffusion capacity, blood gas analysis and multidetector computed tomography (MDCT) scan following C...
Given the pathophysiology of coronavirus disease 19 (COVID-19), persistent pulmonary abnormalities are feared.We conducted a French prospective cohort study in severe COVID-19 patients who had oxygen saturation
Conclusions: Our data is suggestive of a COVID-induced pro-thrombotic state which appears to be present even in those with mild-moderate disease. Our findings support a higher risk profile in those presenting with PE during the COVID pandemic and the presenting symptomatology suggests a need to recognise persistent, sub-acute breathlessness as a potential symptom of PE, rather than attributing it to uncomplicated COVID-19 recovery.
Conclusions: In Covid-19 patients not receiving high level care, VTE risk is not insignificant. As per known data, D dimers are not useful and clinical risk assessment is useful. Patients tend to be co-morbid, male, with an above average BMI and a lower than average frailty score.