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- Li Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Xiaokai Feng
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, China (X.F., C.J., Liming Zhang).
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- Danqing Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Chunguo Jiang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, China (X.F., C.J., Liming Zhang).
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- Heng Mei
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (H.M., Y.H.).
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- Jing Wang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Cuihong Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Hong Li
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Xiaoling Xia
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Shuangshuang Kong
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Jia Liao
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Huijun Jia
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Xueqin Pang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Yue Song
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Ying Tian
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Bin Wang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Chun Wu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Hongliang Yuan
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Yongxing Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Yuman Li
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Wei Sun
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Yanting Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Shuangshuang Zhu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Shuyuan Wang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Yuji Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
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- Shuping Ge
- Department of Pediatrics, St Christopher’s Hospital for Children, Tower Health and Drexel University, Philadelphia, PA (S.G.).
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- Liming Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, China (X.F., C.J., Liming Zhang).
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- Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (H.M., Y.H.).
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- Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
書誌事項
- タイトル別名
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- Prevalence, Risk Factors, and Outcome
抄録
<jats:sec> <jats:title>Background:</jats:title> <jats:p>To investigate deep vein thrombosis (DVT) in hospitalized patients with coronavirus disease 2019 (COVID-19), we performed a single institutional study to evaluate its prevalence, risk factors, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We studied a total of 143 patients with COVID-19 from January 29, 2020 to February 29, 2020. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities, and outcome variables were obtained, and comparisons were made between groups with and without DVT.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> Of the 143 patients hospitalized with COVID-19 (age 63±14 years, 74 [51.7%] men), 66 patients developed lower extremity DVT (46.1%: 23 [34.8%] with proximal DVT and 43 [65.2%] with distal DVT). Compared with patients who did not have DVT, patients with DVT were older and had a lower oxygenation index, a higher rate of cardiac injury, and worse prognosis, including an increased proportion of deaths (23 [34.8%] versus 9 [11.7%]; <jats:italic>P</jats:italic> =0.001) and a decreased proportion of patients discharged (32 [48.5%] versus 60 [77.9%]; <jats:italic>P</jats:italic> <0.001). Multivariant analysis showed an association only between CURB-65 (confusion status, urea, respiratory rate, and blood pressure) score 3 to 5 (odds ratio, 6.122; <jats:italic>P</jats:italic> =0.031), Padua prediction score ≥4 (odds ratio, 4.016; <jats:italic>P</jats:italic> =0.04), D-dimer >1.0 μg/mL (odds ratio, 5.818; <jats:italic>P</jats:italic> <0.014), and DVT in this cohort, respectively. The combination of a CURB-65 score 3 to 5, a Padua prediction score ≥4, and D-dimer >1.0 μg/mL has a sensitivity of 88.52% and a specificity of 61.43% for screening for DVT. In the subgroup of patients with a Padua prediction score ≥4 and whose ultrasound scans were performed >72 hours after admission, DVT was present in 18 (34.0%) patients in the subgroup receiving venous thromboembolism prophylaxis versus 35 (66.0%) patients in the nonprophylaxis group ( <jats:italic>P</jats:italic> =0.010). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>The prevalence of DVT is high and is associated with adverse outcomes in hospitalized patients with COVID-19. Prophylaxis for venous thromboembolism may be protective in patients with a Padua protection score ≥4 after admission. Our data seem to suggest that COVID-19 is probably an additional risk factor for DVT in hospitalized patients.</jats:p> </jats:sec>
収録刊行物
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- Circulation
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Circulation 142 (2), 114-128, 2020-07-14
Ovid Technologies (Wolters Kluwer Health)