Mortalidade nos pacientes com e sem trombose venosa profunda com SARS-COV-2

Abstract

Introduction: Among the most serious epidemics, the SARS-CoV-2 pandemic is marked by a large number of infected people, a fast global spread, and the possibility of serious and even deadly complications. A pro-thrombotic state is seen during SARS-CoV-2 infection, and its pathophysiology is linked to the receptor that the virus uses to enter the host cell as well as an insufficient and exacerbated inflammatory response. This process, also known as immunothrombosis, appears to be a potential explanation for the greater formation of thrombi in patients with COVID-19, which may contribute to their morbidity and mortality. Objective: To evaluate the mortality of patients with deep vein thrombosis (DVT) compared to A cross-sectional study was carried out in which the medical records of patients with COVID-19 who underwent evaluation of the venous system of both lower limbs by color Doppler ultrasound (CDUS) to investigate DVT and its influence on mortality between the groups with and without DVT were analyzed using Fisher's exact test. Consecutive patients were selected up to complete 100 with a diagnosis of DVT and 100 without. Results: Death rates were 67% in the DVTdiagnosed group and 31% in the DVT-negative group. Fisher's exact test revealed that this difference was statistically significant (p = 0.0001). Regardless of DVT, a median D-dimer analysis was performed on every patient who passed away. In the group that experienced a positive clinical outcome, the result was 3.48 μd/ml, whereas the overall result was 9.51 μd/ml. The data did not show statistical significance. However, the D-dimer values among patients without DVT showed a median of 4.8 μd/ml in the group that died and 2,37 μd/ml in the group that survived (Mann-Whitney U test p= 0,006). These findings suggest that the formation of microclots may reflect the severity of the outcomes observed in patients with COVID-19. Conclusions: Based on these results, it was concluded that there was an increase in mortality in patients admitted to ICUs due to COVID- 19 who had DVT. Furthermore, there is a correlation between D-dimer levels and mortality in patients without DVT. These findings have suggested that the prothrombotic state in SARS-CoV-2 due to the immune response may reflect the severity and prognosis of COVID-19