Predictive value of inflammatory and coagulation biomarkers for venous thromboembolism in COVID-19 patients

Author:

Hojker Marta12,Tršan Jure23,Tršan Uroš2,Gale Ana4,Jerman Alexander5,Košuta Daniel23

Affiliation:

1. University Medical Centre Ljubljana, Department of Orthopaedic Surgery, Ljubljana, Slovenia

2. University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia

3. University Medical Centre Ljubljana, Department of Vascular Diseases, Ljubljana, Slovenia

4. University Medical Centre Ljubljana, Department of Dermatovenereology, Ljubljana, Slovenia

5. University Medical Centre Ljubljana, Department of Nephrology, Ljubljana, Slovenia

Abstract

BACKGROUND: The predictive value of coagulation markers for venous thromboembolism (VTE) in COVID-19 patients has been investigated with conflicting results. OBJECTIVE: Our aim was to investigate the correlation between biomarkers and VTE and the predictive value of D-dimer for VTE in hospitalized COVID-19 patients. METHODS: Complete blood count, inflammatory and coagulation biomarkers at admission were collected. VTE was defined as diagnosed pulmonary embolism or deep vein thrombosis. Events were defined as in-hospital death or ICU admission. Predictors of VTE were identified with Pearson prediction models. A ROC curve was constructed to assess the predictive value of D-dimer. RESULTS: 1651 participants were included, 111 VTE were identified. Events incidence was higher in the VTE group (49.5% vs 28.2%, p < 0.001). Neutrophil-lymphocyte ratio (NLR, 0.001; 95% CI 0.000–0.002; p 0.019) and D-dimer (0.00005; 95% CI 0.00002–0.00008; p < 0.001), Geneva score (0.026; 95% CI 0.012–0.040; p < 0.001) and Wells score (0.047; 95% CI 0.033–0.061; p < 0.001) were associated with VTE. D-dimer had a goor predictive value for VTE (ROC area 0.85, 95% CI 0.816–0.893), with an optimal cut-off value of 2677μg/L (Youden index of 0,602). CONCLUSIONS: Among coagulation biomarkers D-dimer had the best predictive value for VTE, but higher cut-off values should be used in COVID-19.

Publisher

IOS Press

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Hematology,Physiology

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