PDF(Pubmed)
Abstract：
The purpose of the study was to investigate baseline inflammatory, hemostatic indicators and new-onset deep vein thrombosis (DVT) with the risk of mortality in COVID-19 inpatients. In this single-center study, a total of 401 COVID-19 patients hospitalized in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were enrolled from December 1, 2022 to January 31, 2023. The basic information, first laboratory examination results, imaging examination, and outcome-related indicators were compared between patients in the moderate and severe subgroups. We found that baseline D-dimer and baseline absolute neutrophil count (ANC) levels were associated with new-onset DVT and death in severe hospitalized patients with COVID-19. The odds ratio (OR) of baseline D-dimer and baseline ANC with mortality was 1.18 (95% confidence interval [CI], 1.08-1.28; P < .001) and 1.13 (95% CI, 1.06-1.21; P < .001). Baseline ANC was associated with the risk of death in severe hospitalized COVID-19 patients, irrespective of the DVT status. In addition, a significantly higher serum neutrophil activity was observed in severe COVID-19 inpatients with DVT or those deceased during hospital stay. New-onset DVT partially mediated the association between baseline D-dimer (indirect effect: 0.011, estimated mediating proportion: 67.0%), baseline ANC (indirect effect: 0.006, estimated mediating proportion: 48.7%), and mortality in severe hospitalized patients with COVID-19. In summary, baseline D-dimer and baseline absolute neutrophil count (ANC) levels were associated with the mortality in severe hospitalized patients with COVID-19, especially DVT inpatients. New-onset DVT partially mediated the association between baseline D-dimer, baseline ANC, and mortality in severe hospitalized patients with COVID-19.
摘要：
该研究的目的是调查基线炎症，在COVID-19住院患者中，止血指标和新发深静脉血栓形成（DVT）与死亡风险有关。在这项单中心研究中，共有401名COVID-19患者在邵逸夫医院住院，浙江大学医学院于2022年12月1日至2023年1月31日入学。基本信息,第一次实验室检查结果，影像学检查,比较中度和重度亚组患者的结局相关指标。我们发现，在重症COVID-19住院患者中，基线D-二聚体和基线中性粒细胞绝对计数（ANC）水平与新发DVT和死亡相关。基线D-二聚体和基线ANC与死亡率的比值比（OR）为1.18（95％置信区间[CI]，1.08-1.28；P<.001）和1.13（95%CI，1.06-1.21；P<.001）。基线ANC与重症住院COVID-19患者的死亡风险相关，无论DVT状态如何。此外,在患有DVT的严重COVID-19住院患者或住院期间死亡患者中,观察到血清中性粒细胞活性显著升高.新发DVT部分介导基线D-二聚体之间的关联（间接效应：0.011，估计介导比例：67.0%），基线ANC（间接效应：0.006，估计中介比例：48.7%），严重COVID-19住院患者的死亡率。总之,在重症COVID-19住院患者,尤其是DVT住院患者中,基线D-二聚体和基线中性粒细胞绝对计数(ANC)水平与死亡率相关.新发DVT部分介导了基线D-二聚体之间的关联，基线ANC,严重COVID-19住院患者的死亡率。
