Systematic Screening for Venous Thromboembolic Events in COVID-19 Pneumonia
Gaël Grandmaison, A Bogdan Andrey, Daniel Périard, Rolf P. Engelberger, Guillaume Carrel, Sébastien Doll, Jean-Baptiste Dexpert, Caroline Krieger, Hatem Ksouri, Daniel Hayoz, Govind Sridharan
Abstract
The new coronavirus disease 2019 (COVID-19) pandemic spreads worldwide, provoking pneumonia, acute respiratory distress syndrome (ARDS) and death. Recently, the medical community has been alerted by reports of coagulation disorders,[1] [2] with arterial and venous thromboembolic events (VTEs) among patients with acute COVID-19.[3] [4] [5] [6] [7] [8] [9] This disproportionate incidence of vascular events seems to be linked to a strong inflammatory response against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and to an infection of endothelial cells, with endotheliitis, viral inclusions and endothelial cells apoptosis.[10] [11] This systemic endothelial injury, associated with the host inflammatory response against SARS-CoV-2, results in activation of coagulation with arterial, venous, catheter and dialysis filter thromboses. Despite several reports, the incidence of VTEs is not precisely known. As VTE is a treatable condition that may adversely affect the survival of already severely compromised patients, we performed a single cross-sectional systematic search for VTEs among the COVID-19 patients in the intensive care unit (ICU) and medicine ward.