Systematic assessment of venous thromboembolism in COVID-19 patients receiving thromboprophylaxis: incidence and role of D-dimer as predictive factors.
Identifieur interne : 000530 ( Main/Exploration ); précédent : 000529; suivant : 000531Systematic assessment of venous thromboembolism in COVID-19 patients receiving thromboprophylaxis: incidence and role of D-dimer as predictive factors.
Auteurs : Mathieu Artifoni [France] ; Gwenvael Danic [France] ; Giovanni Gautier [France] ; Pascal Gicquel [France] ; David Boutoille [France] ; François Raffi [France] ; Antoine Néel [France] ; Raphaël Lecomte [France]Source :
- Journal of thrombosis and thrombolysis [ 1573-742X ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Anticoagulants (usage thérapeutique), Femelle (MeSH), France (épidémiologie), Humains (MeSH), Incidence (MeSH), Infections à coronavirus (complications), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (complications), Produits de dégradation de la fibrine et du fibrinogène (métabolisme), Sujet âgé (MeSH), Thromboembolisme veineux (prévention et contrôle), Thromboembolisme veineux (sang), Thromboembolisme veineux (virologie), Thromboembolisme veineux (épidémiologie), Énoxaparine (usage thérapeutique), Études rétrospectives (MeSH).
- MESH :
- métabolisme : Infections à coronavirus, Pneumopathie virale, Produits de dégradation de la fibrine et du fibrinogène.
- prévention et contrôle : Thromboembolisme veineux.
- sang : Thromboembolisme veineux.
- usage thérapeutique : Anticoagulants, Énoxaparine.
- virologie : Thromboembolisme veineux.
- épidémiologie : France, Thromboembolisme veineux.
- Adulte d'âge moyen, Femelle, Humains, Incidence, Mâle, Pandémies, Sujet âgé, Études rétrospectives.
- Wicri :
- geographic : France.
English descriptors
- KwdEn :
- Aged (MeSH), Anticoagulants (therapeutic use), Coronavirus Infections (complications), Enoxaparin (therapeutic use), Female (MeSH), Fibrin Fibrinogen Degradation Products (metabolism), France (epidemiology), Humans (MeSH), Incidence (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Retrospective Studies (MeSH), Venous Thromboembolism (blood), Venous Thromboembolism (epidemiology), Venous Thromboembolism (prevention & control), Venous Thromboembolism (virology).
- MESH :
- chemical , metabolism : Fibrin Fibrinogen Degradation Products.
- chemical , therapeutic use : Anticoagulants, Enoxaparin.
- geographic , epidemiology : France.
- blood : Venous Thromboembolism.
- complications : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Venous Thromboembolism.
- prevention & control : Venous Thromboembolism.
- virology : Venous Thromboembolism.
- Aged, Female, Humans, Incidence, Male, Middle Aged, Pandemics, Retrospective Studies.
Abstract
Coagulopathy in COVID-19 is a burning issue and strategies to prevent thromboembolic events are debated and highly heterogeneous. The objective was to determine incidence and risk factors of venous thromboembolism (VTE) in COVID-19 inpatients receiving thromboprophylaxis. In this retrospective French cohort study, patients hospitalized in medical wards non-ICU with confirmed COVID-19 and adequate thromboprophylaxis were included. A systematic low limb venous duplex ultrasonography was performed at hospital discharge or earlier if deep venous thrombosis (DVT) was clinically suspected. Chest angio-CT scan was performed when pulmonary embolism (PE) was suspected. Of 71 patients, 16 developed VTE (22.5%) and 7 PE (10%) despite adequate thromboprophylaxis. D-dimers at baseline were significantly higher in patients with DVT (p < 0.001). Demographics, comorbidities, disease manifestations, severity score, and other biological parameters, including inflammatory markers, were similar in patients with and without VTE. The negative predictive value of a baseline D-dimer level < 1.0 µg/ml was 90% for VTE and 98% for PE. The positive predictive value for VTE was 44% and 67% for D-dimer level ≥ 1.0 µg/ml and ≥ 3 µg/ml, respectively. The association between D-dimer level and VTE risk increased by taking into account the latest available D-dimer level prior to venous duplex ultrasonography for the patients with monitoring of D-dimer. Despite thromboprophylaxis, the risk of VTE is high in COVID-19 non-ICU inpatients. Increased D-dimer concentrations of more than 1.0 μg/ml predict the risk of venous thromboembolism. D-dimer level-guided aggressive thromboprophylaxis regimens using higher doses of heparin should be evaluated in prospective studies.
DOI: 10.1007/s11239-020-02146-z
PubMed: 32451823
PubMed Central: PMC7246965
Affiliations:
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wicri:step="Curation">001116</idno><idno type="wicri:Area/Main/Exploration">001116</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Systematic assessment of venous thromboembolism in COVID-19 patients receiving thromboprophylaxis: incidence and role of D-dimer as predictive factors.</title><author><name sortKey="Artifoni, Mathieu" sort="Artifoni, Mathieu" uniqKey="Artifoni M" first="Mathieu" last="Artifoni">Mathieu Artifoni</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Interne, CHU de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Danic, Gwenvael" sort="Danic, Gwenvael" uniqKey="Danic G" first="Gwenvael" last="Danic">Gwenvael Danic</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Interne, CHU de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Gautier, Giovanni" sort="Gautier, Giovanni" uniqKey="Gautier G" first="Giovanni" last="Gautier">Giovanni Gautier</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Interne, CHU de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Gicquel, Pascal" sort="Gicquel, Pascal" uniqKey="Gicquel P" first="Pascal" last="Gicquel">Pascal Gicquel</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Polyvalente, CH de Châteaubriant, 44110, Châteaubriant, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Polyvalente, CH de Châteaubriant, 44110, Châteaubriant</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Châteaubriant</settlement></placeName></affiliation></author><author><name sortKey="Boutoille, David" sort="Boutoille, David" uniqKey="Boutoille D" first="David" last="Boutoille">David Boutoille</name><affiliation wicri:level="3"><nlm:affiliation>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Raffi, Francois" sort="Raffi, Francois" uniqKey="Raffi F" first="François" last="Raffi">François Raffi</name><affiliation wicri:level="3"><nlm:affiliation>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Neel, Antoine" sort="Neel, Antoine" uniqKey="Neel A" first="Antoine" last="Néel">Antoine Néel</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Interne, CHU de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Faculté de Médecine, Université de Nantes, 44093, Nantes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculté de Médecine, Université de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName><orgName type="university">Université de Nantes</orgName></affiliation></author><author><name sortKey="Lecomte, Raphael" sort="Lecomte, Raphael" uniqKey="Lecomte R" first="Raphaël" last="Lecomte">Raphaël Lecomte</name><affiliation wicri:level="3"><nlm:affiliation>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes, France. raphael.lecomte@chu-nantes.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes, France. raphael.lecomte@chu-nantes.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author></analytic><series><title level="j">Journal of thrombosis and thrombolysis</title><idno type="eISSN">1573-742X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Anticoagulants (therapeutic use)</term><term>Coronavirus Infections (complications)</term><term>Enoxaparin (therapeutic use)</term><term>Female (MeSH)</term><term>Fibrin Fibrinogen Degradation Products (metabolism)</term><term>France (epidemiology)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Retrospective Studies (MeSH)</term><term>Venous Thromboembolism (blood)</term><term>Venous Thromboembolism (epidemiology)</term><term>Venous Thromboembolism (prevention & control)</term><term>Venous Thromboembolism (virology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Anticoagulants (usage thérapeutique)</term><term>Femelle (MeSH)</term><term>France (épidémiologie)</term><term>Humains (MeSH)</term><term>Incidence (MeSH)</term><term>Infections à coronavirus (complications)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Produits de dégradation de la fibrine et du fibrinogène (métabolisme)</term><term>Sujet âgé (MeSH)</term><term>Thromboembolisme veineux (prévention et contrôle)</term><term>Thromboembolisme veineux (sang)</term><term>Thromboembolisme veineux (virologie)</term><term>Thromboembolisme veineux (épidémiologie)</term><term>Énoxaparine (usage thérapeutique)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Fibrin Fibrinogen Degradation Products</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anticoagulants</term><term>Enoxaparin</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>France</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Venous Thromboembolism</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Venous Thromboembolism</term></keywords><keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term><term>Produits de dégradation de la fibrine et du fibrinogène</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Venous Thromboembolism</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Thromboembolisme veineux</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Thromboembolisme veineux</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anticoagulants</term><term>Énoxaparine</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Thromboembolisme veineux</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Venous Thromboembolism</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>France</term><term>Thromboembolisme veineux</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Mâle</term><term>Pandémies</term><term>Sujet âgé</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>France</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Coagulopathy in COVID-19 is a burning issue and strategies to prevent thromboembolic events are debated and highly heterogeneous. The objective was to determine incidence and risk factors of venous thromboembolism (VTE) in COVID-19 inpatients receiving thromboprophylaxis. In this retrospective French cohort study, patients hospitalized in medical wards non-ICU with confirmed COVID-19 and adequate thromboprophylaxis were included. A systematic low limb venous duplex ultrasonography was performed at hospital discharge or earlier if deep venous thrombosis (DVT) was clinically suspected. Chest angio-CT scan was performed when pulmonary embolism (PE) was suspected. Of 71 patients, 16 developed VTE (22.5%) and 7 PE (10%) despite adequate thromboprophylaxis. D-dimers at baseline were significantly higher in patients with DVT (p < 0.001). Demographics, comorbidities, disease manifestations, severity score, and other biological parameters, including inflammatory markers, were similar in patients with and without VTE. The negative predictive value of a baseline D-dimer level < 1.0 µg/ml was 90% for VTE and 98% for PE. The positive predictive value for VTE was 44% and 67% for D-dimer level ≥ 1.0 µg/ml and ≥ 3 µg/ml, respectively. The association between D-dimer level and VTE risk increased by taking into account the latest available D-dimer level prior to venous duplex ultrasonography for the patients with monitoring of D-dimer. Despite thromboprophylaxis, the risk of VTE is high in COVID-19 non-ICU inpatients. Increased D-dimer concentrations of more than 1.0 μg/ml predict the risk of venous thromboembolism. D-dimer level-guided aggressive thromboprophylaxis regimens using higher doses of heparin should be evaluated in prospective studies.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32451823</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>19</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1573-742X</ISSN><JournalIssue CitedMedium="Internet"><Volume>50</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Journal of thrombosis and thrombolysis</Title><ISOAbbreviation>J. Thromb. Thrombolysis</ISOAbbreviation></Journal><ArticleTitle>Systematic assessment of venous thromboembolism in COVID-19 patients receiving thromboprophylaxis: incidence and role of D-dimer as predictive factors.</ArticleTitle><Pagination><MedlinePgn>211-216</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s11239-020-02146-z</ELocationID><Abstract><AbstractText>Coagulopathy in COVID-19 is a burning issue and strategies to prevent thromboembolic events are debated and highly heterogeneous. The objective was to determine incidence and risk factors of venous thromboembolism (VTE) in COVID-19 inpatients receiving thromboprophylaxis. In this retrospective French cohort study, patients hospitalized in medical wards non-ICU with confirmed COVID-19 and adequate thromboprophylaxis were included. A systematic low limb venous duplex ultrasonography was performed at hospital discharge or earlier if deep venous thrombosis (DVT) was clinically suspected. Chest angio-CT scan was performed when pulmonary embolism (PE) was suspected. Of 71 patients, 16 developed VTE (22.5%) and 7 PE (10%) despite adequate thromboprophylaxis. D-dimers at baseline were significantly higher in patients with DVT (p < 0.001). Demographics, comorbidities, disease manifestations, severity score, and other biological parameters, including inflammatory markers, were similar in patients with and without VTE. The negative predictive value of a baseline D-dimer level < 1.0 µg/ml was 90% for VTE and 98% for PE. The positive predictive value for VTE was 44% and 67% for D-dimer level ≥ 1.0 µg/ml and ≥ 3 µg/ml, respectively. The association between D-dimer level and VTE risk increased by taking into account the latest available D-dimer level prior to venous duplex ultrasonography for the patients with monitoring of D-dimer. Despite thromboprophylaxis, the risk of VTE is high in COVID-19 non-ICU inpatients. Increased D-dimer concentrations of more than 1.0 μg/ml predict the risk of venous thromboembolism. D-dimer level-guided aggressive thromboprophylaxis regimens using higher doses of heparin should be evaluated in prospective studies.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Artifoni</LastName><ForeName>Mathieu</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Service de Médecine Interne, CHU de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Danic</LastName><ForeName>Gwenvael</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Service de Médecine Interne, CHU de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gautier</LastName><ForeName>Giovanni</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Service de Médecine Interne, CHU de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gicquel</LastName><ForeName>Pascal</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Service de Médecine Polyvalente, CH de Châteaubriant, 44110, Châteaubriant, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boutoille</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Raffi</LastName><ForeName>François</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Néel</LastName><ForeName>Antoine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de Médecine Interne, CHU de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de Médecine, Université de Nantes, 44093, Nantes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lecomte</LastName><ForeName>Raphaël</ForeName><Initials>R</Initials><Identifier Source="ORCID">http://orcid.org/0000-0003-2144-9221</Identifier><AffiliationInfo><Affiliation>Service de Maladies Infectieuses et Tropicales, CHU de Nantes, 44093, Nantes, France. raphael.lecomte@chu-nantes.fr.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIC UIC 1413 INSERM, CHU de Nantes, 44093, Nantes, France. raphael.lecomte@chu-nantes.fr.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>J Thromb Thrombolysis</MedlineTA><NlmUniqueID>9502018</NlmUniqueID><ISSNLinking>0929-5305</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000925">Anticoagulants</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D017984">Enoxaparin</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D005338">Fibrin Fibrinogen Degradation Products</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C036309">fibrin fragment D</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000925" MajorTopicYN="N">Anticoagulants</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017984" MajorTopicYN="N">Enoxaparin</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005338" MajorTopicYN="N">Fibrin Fibrinogen Degradation Products</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005602" MajorTopicYN="N" Type="Geographic">France</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D054556" MajorTopicYN="N">Venous Thromboembolism</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">D-dimer</Keyword><Keyword MajorTopicYN="N">Pulmonary embolism</Keyword><Keyword MajorTopicYN="N">Venous thromboembolism</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>5</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>6</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>5</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32451823</ArticleId><ArticleId IdType="doi">10.1007/s11239-020-02146-z</ArticleId><ArticleId IdType="pii">10.1007/s11239-020-02146-z</ArticleId><ArticleId IdType="pmc">PMC7246965</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><region><li>Pays de la Loire</li></region><settlement><li>Châteaubriant</li><li>Nantes</li></settlement><orgName><li>Université de Nantes</li></orgName></list><tree><country name="France"><region name="Pays de la Loire"><name sortKey="Artifoni, Mathieu" sort="Artifoni, Mathieu" uniqKey="Artifoni M" first="Mathieu" last="Artifoni">Mathieu Artifoni</name></region><name sortKey="Boutoille, David" sort="Boutoille, David" uniqKey="Boutoille D" first="David" last="Boutoille">David Boutoille</name><name sortKey="Boutoille, David" sort="Boutoille, David" uniqKey="Boutoille D" first="David" last="Boutoille">David Boutoille</name><name sortKey="Danic, Gwenvael" sort="Danic, Gwenvael" uniqKey="Danic G" first="Gwenvael" last="Danic">Gwenvael Danic</name><name sortKey="Gautier, Giovanni" sort="Gautier, Giovanni" uniqKey="Gautier G" first="Giovanni" last="Gautier">Giovanni Gautier</name><name sortKey="Gicquel, Pascal" sort="Gicquel, Pascal" uniqKey="Gicquel P" first="Pascal" last="Gicquel">Pascal Gicquel</name><name sortKey="Lecomte, Raphael" sort="Lecomte, Raphael" uniqKey="Lecomte R" first="Raphaël" last="Lecomte">Raphaël Lecomte</name><name sortKey="Lecomte, Raphael" sort="Lecomte, Raphael" uniqKey="Lecomte R" first="Raphaël" last="Lecomte">Raphaël Lecomte</name><name sortKey="Neel, Antoine" sort="Neel, Antoine" uniqKey="Neel A" first="Antoine" last="Néel">Antoine Néel</name><name sortKey="Neel, Antoine" sort="Neel, Antoine" uniqKey="Neel A" first="Antoine" last="Néel">Antoine Néel</name><name sortKey="Raffi, Francois" sort="Raffi, Francois" uniqKey="Raffi F" first="François" last="Raffi">François Raffi</name><name sortKey="Raffi, Francois" sort="Raffi, Francois" uniqKey="Raffi F" first="François" last="Raffi">François Raffi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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