Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul;20(4):e76-e81.
doi: 10.7861/clinmed.2020-0228. Epub 2020 May 18.

Thrombotic risk in COVID-19: a case series and case-control study

Simon M Stoneham  1 , Kate M Milne  2 , Elisabeth Nuttall  3 , Georgina H Frew  3 , Beattie Rh Sturrock  4 , Helena Sivaloganathan  5 , Eleni E Ladikou  5 , Stephen Drage  3 , Barbara Phillips  5 , Timothy Jt Chevassut  6 , Alice C Eziefula  5
Affiliations

Thrombotic risk in COVID-19: a case series and case-control study

Simon M Stoneham et al. Clin Med (Lond). 2020 Jul.

Abstract

Background: A possible association between COVID-19 infection and thrombosis, either as a direct consequence of the virus or as a complication of inflammation, is emerging in the literature. Data on the incidence of venous thromboembolism (VTE) are extremely limited.

Methods: We describe three cases of thromboembolism refractory to heparin treatment, the incidence of VTE in an inpatient cohort, and a case-control study to identify risk factors associated with VTE.

Results: We identified 274 confirmed (208) or probable (66) COVID-19 patients. 21 (7.7%) were diagnosed with VTE. D-dimer was elevated in both cases (confirmed VTE) and controls (no confirmed VTE) but higher levels were seen in confirmed VTE cases (4.1 vs 1.2 μg/mL, p<0.001).

Conclusion: Incidence of VTE is high in patients hospitalised with COVID-19. Urgent clinical trials are needed to evaluate the role of anticoagulation in COVID-19. Monitoring of D-dimer and anti-factor Xa levels may be beneficial in guiding management.

Keywords: COVID-19; D-dimer; deep vein thrombosis; pulmonary embolism; venous thromboembolism.

PubMed Disclaimer

References

    1. World Health Organisation Health topics (2020). Available from www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-1... [Accessed 18 April 2020].
    1. Chen Tao, Wu Di, Chen Huilong, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020;368:m1091. - PMC - PubMed
    1. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020;18:844–7. - PMC - PubMed
    1. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054–62. - PMC - PubMed
    1. Lippi G, Favaloro EJ. D-dimer is associated with severity of coronavirus disease 2019: a pooled analysis. Thromb Haemost 2020;120:876–8. - PMC - PubMed

MeSH terms