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Thromb Haemost 2022; 122(09): 1567-1572
DOI: 10.1055/a-1788-7592
Stroke, Systemic or Venous Thromboembolism

The ADA (Age-D-Dimer-Albumin) Score to Predict Thrombosis in SARS-CoV-2

Francesco Violi 
1   Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
2   Mediterranea Cardiocentro-Napoli, Napoli, Italy
,
Pasquale Pignatelli
1   Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
2   Mediterranea Cardiocentro-Napoli, Napoli, Italy
,
Anna Rita Vestri
3   Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
,
Alessandra Spagnoli
3   Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
,
Francesco Cipollone
4   Clinica Medica, Department of Medicine and Aging, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy
,
Giancarlo Ceccarelli
3   Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
,
Alessandra Oliva
3   Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
,
Maria Amitrano
5   Internal Medicine Unit, Moscati Hospital, Avellino, Italy
,
Matteo Pirro
6   Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
,
Gloria Taliani
7   Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
,
Roberto Cangemi
7   Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
,
Miriam Lichtner
3   Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
,
Francesco Pugliese
3   Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
,
Marco Falcone
8   Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
,
Damiano D'Ardes
4   Clinica Medica, Department of Medicine and Aging, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy
,
Mario Venditti
3   Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
,
Claudio Maria Mastroianni
3   Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
,
Lorenzo Loffredo 
1   Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
,
the ADA GROUP
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Abstract

Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-related pneumonia is associated with venous and arterial thrombosis. Aim of the study was to find out a new score for predicting thrombosis in patients with SARS-CoV-2.

Methods We included a cohort of 674 patients affected by SARS-CoV-2, not requiring intensive care units, and followed-up during the hospitalization until discharge. Routine analyses performed at in-hospital admission included also serum albumin and D-dimer while arterial and venous thromboses were the endpoints of the study.

Results During the follow-up, 110 thrombotic events were registered; patients with thrombotic events were older and had lower albumin and higher D-dimer, compared with thrombotic event-free ones. On multivariable logistic regression with step-by-step procedure age, serum albumin, and D-dimer were independently associated with thrombotic events. The linear combination of age, D-dimer, and albumin allowed to build-up the ADA (age-D-dimer-albumin) score, whose area under the curve (AUC) was 0.752 (95% confidence interval [CI], 0.708–0.795). ADA score was internally validated by bootstrap sampling procedure giving an AUC of 0.752 (95% CI: 0.708–0.794).

Conclusion Combination of age, D-dimer, and albumin in the ADA score allows identifying SARS-CoV-2 patients at higher risk of thrombotic events.

Keywords

venous thrombosis - viral infection - thrombosis

Supplementary Material



Publication History

Received: 10 September 2021

Accepted: 10 February 2022

Accepted Manuscript online:
04 March 2022

Article published online:
18 July 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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