Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy
Authors: Melazzini Federica , Colaneri Marta , Fumoso Federica , Freddi Giulia , Lenti Marco Vincenzo , Pieri Teresa Chiara , Piloni Davide , Noris Patrizia , Pieresca Carla , Preti Paola Stefania , Russo Mariaconcetta , Corsico Angelo , Tavazzi Guido , Baldanti Fausto , Triarico Antonio , Mojoli Francesco , Bruno Raffaele , Di Sabatino Antonio ,   on behalf of the San Matteo Pavia COVID-19 Task Force, Aronico Nicola , Bergamaschi Gaetano , Bertolino Giampiera , Codega Silvia , Costanzo Filippo , Cresci Roberto , Delliponti Angela , Derosa Giuseppe , Di Stefano Michele , Falaschi Francesco , Iadarola Carmine , Lovati Elisabetta , Lucotti Pietro Carlo , Martignoni Alessandra , Mengoli Caterina , Miceli Emanuela , Mugellini Amedeo , Muggia Chiara , Pagani Elisabetta , Palumbo Ilaria , Pecci Alessandro , Perrone Tiziano , Sgarlata Carmelo , Siciliani Luisa , Staniscia Andrea , Vjera Francesca Torello , Achilli Giovanna , Agostinelli Andrea , Antoci Valentina , Ballesio Alessia , Banfi Francesco , Barteselli Chiara , Benedetti Irene , de Andreis Federica Borrelli , Brattoli Michele , Calabretta Francesca , Cambiè Ginevra , Canta Roberta , Conca Federico , Coppola Luigi , Cremonte Elisa Maria , Croce Gabriele , Del Rio Virginia , Di Terlizzi Francesco , Ferrari Maria Giovanna , Ferrari Sara , Fiengo Anna , Forni Tommaso , Frigerio Chiara , Fusco Alessandra , Gabba Margherita , Garolfi Matteo , Gentile Antonella , Gori Giulia , Grandi Giacomo , Grimaldi Paolo , Lampugnani Alice , Lapia Francesco , Lepore Federica , Lettieri Gianluca , Mambella Jacopo , Mercanti Chiara , Merli Stefania , Mordà Francesco , Nardone Alba , Pace Luca , Padovini Lucia , Parodi Alessandro , Pellegrino Ivan , Pitotti Lavinia , Reduzzi Margherita , Rigano Giovanni , Romito Giovanni , Rotola Giorgio , Sabatini Umberto , Salvi Lucia , Santacroce Giovanni , Savioli Jessica , Soriano Simone , Spataro Carmine , Stefani Debora , Aliberti Anna Rita , Amatu Alessandro , Anfossi Laura , Arisi Eric , Baldi Chiara , Belliato Mirko , Bellini Lorenzo , Benzi Alberto , Bichisao Germana , Bolongaro Antonia , Bottazzi Andrea , Broglia Federica , Bruschi Giacomo , Caneva Luca , Capaccio Emanuele , Carboni Valeria , Cavalloro Fabrizio , Ciceri Maria , Civardi Luca , Delmonte Maria Paola , Domenegati Elisa Lucia , Ferrari Federica , Ferrari Fiorenza , Ferrari Marta , Fuardo Marinella , Gerletti Maddalena Margherita , Gualdana Simonetta , Ilardi Marcella , Lo Coco Claudia , Maggio Giuseppe , Mascia Maria Benedetta , Mencherini Simonetta , Merati Paola Maria , Mongodi Silvia , Mori Anna Maria , Morgante Federica , Niebel Thekla Larissa , Noli Silvano , Orlando Anita , Pagani Michele , Passador Debora , Pellicori Simona , Perotti Luciano , Picchioni Raffaella , Poma Silvia , Pozzi Marco , Preti Emanuela , Puce Roberta , Radolovich Danila Katia , Ragni Gianluca , Repossi Filippo , Riccardi Francesca , Rizzardi Roberto , Rodi Giuseppe , Roldi Emanuela , Romito Giovanni , Rossi Cristina , Sala Gallini Giuseppe , Sciutti Fabio , Sportiello Debora , Ticozzelli Giulia , Visconti Federico , Zizzi Silvia , Bagliani Alessandro , Belotti Corrado , Bossi Chiara , Colombo Andrea , Colombo Costanza Natalia Julia , Cremascoli Luca , Dammassa Valentino , Discepoli Roberto , Garlando Maria Adelaide , Grandini Filippo , Pellegrini Andrea , Quaranta Cecilia , Stella Andrea , Torresani Francesco , Mondelli Mario , Brunetti Enrico , Di Matteo Angela , Seminari Elena , Maiocchi Laura , Zuccaro Valentina , Pagnucco Layla , Mariani Bianca , Ludovisi Serena , Lissandrin Raffaella , Parisi Aldo , Sacchi Paolo , Patruno Savino F. A. , Michelone Giuseppe , Gulminetti Roberto , Zanaboni Domenico , Novati Stefano , Maserati Renato , Orsolini Paolo , Vecchia Marco , Asperges Erika , Di Filippo Alessandro , Sambo Margherita , Biscarini Simona , Lupi Matteo , Roda Silvia , Gallazzi Ilaria , Sachs Michele , Valsecchi Pietro , Ferrari Alessandra , Mariani Bianca , Bosio Matteo , Cascina Alessandro , Conio Valentina , Di Domenica Rita , Donnetta Anna , Fraolini Elia , Gualtieri Giuseppe , Mangiarotti Patrizia , Mariani Francesca , Meloni Federica , Oggionni Tiberio , Pasturenzi Lidia , Ronzoni Vanessa , Saracino Laura , Stella Giulia , Tomaselli Stefano , Abbate Tommaso , Accordino Giulia , Bertuccio Francesco , Burattini Cecilia , Cacciatore Elisa , Cattaneo Elena , Chino Vittorio , Coretti Manuela , Della Zoppa Matteo , Infusino Cristina , Lettieri Sara , Maccabruni Valeria , Mancinelli Silvia , Tirelli Claudio , Vertui Valentina 
Published: November 2020

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.