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Journal Articles Intensive Care Medicine Year : 2020

Prothrombotic phenotype in COVID-19 severe patients

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Julie Helms
  • Function : Author
  • PersonId : 1076641
Hamid Merdji
  • Function : Author
Eduardo Angles-Cano
  • Function : Author
Ferhat Meziani
  • Function : Author
  • PersonId : 1076640

Abstract

In our study, CTPA was performed in a population in which we were looking for a cause to clinical deterioration, which might be due to PE, but also to mechanical ventilation-acquired pneumonia. We therefore did not necessarily select a population with a strong suspicion of PE. We did not have a systematic standardized assessment of thromboembolic events as well. Imaging was thus performed based on the evolution of clinical or laboratory parameters. Respiratory (PaO2/FiO2) or hemodynamic deterioration, or evidence of dilated right ventricle—even without acute cor pulmonale—was explored by CTPA. A rapid elevation of D-dimer despite anticoagulation, reflecting increased thrombin generation, i.e., clot formation, and fibrinolysis, was investigated. D-dimer level did not differ at baseline between patients with/without pulmonary embolism, but increased with thrombotic events during ICU stay, with D-dimers > 5 mg/L in 92% of the patients. A sudden increase in D-dimer level along with clinical deterioration was an additional argument to explore patients by CTPA.

Dates and versions

hal-03603568 , version 1 (09-03-2022)

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Julie Helms, François Severac, Hamid Merdji, Eduardo Angles-Cano, Ferhat Meziani. Prothrombotic phenotype in COVID-19 severe patients. Intensive Care Medicine, 2020, 46 (7), pp.1502-1503. ⟨10.1007/s00134-020-06082-7⟩. ⟨hal-03603568⟩
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