{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:31:14Z","timestamp":1790220674604,"version":"4.1.0"},"reference-count":45,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Critically ill COVID-19 patients are at high risk for venous thromboembolism (VTE), namely deep vein thrombosis (DVT) and\/or pulmonary embolism (PE), and death. The optimal anticoagulation strategy in critically ill patients with COVID-19 remains unknown. This study investigated the ante mortem incidence as well as postmortem prevalence of VTE, the factors predictive of VTE, and the impact of changed anticoagulation practice on patient survival. We conducted a consecutive retrospective analysis of postmortem COVID-19 (n = 64) and non-COVID-19 (n = 67) patients, as well as ante mortem COVID-19 (n = 170) patients admitted to the University Medical Center Hamburg-Eppendorf (Hamburg, Germany). Baseline patient characteristics, parameters related to the intensive care unit (ICU) stay, and the clinical and autoptic presence of VTE were evaluated and statistically compared between groups. The occurrence of VTE in critically ill COVID-19 patients is confirmed in both ante mortem (17%) and postmortem (38%) cohorts. Accordingly, comparing the postmortem prevalence of VTE between age- and sex-matched COVID-19 (43%) and non-COVID-19 (0%) cohorts, we found the statistically significant increased prevalence of VTE in critically ill COVID-19 cohorts (p = 0.001). A change in anticoagulation practice was associated with the statistically significant prolongation of survival time (HR: 2.55, [95% CI 1.41\u20134.61], p = 0.01) and a reduction in VTE occurrence (54% vs. 25%; p = 0.02). In summary, in the autopsy as well as clinical cohort of critically ill patients with COVID-19, we found that VTE was a frequent finding. A change in anticoagulation practice was associated with a statistically significantly prolonged survival time.<\/jats:p>","DOI":"10.3390\/v14040811","type":"journal-article","created":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:22:43Z","timestamp":1650414163000},"page":"811","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["New Insights in the Occurrence of Venous Thromboembolism in Critically Ill Patients with COVID-19\u2014A Large Postmortem and Clinical Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2922-4863","authenticated-orcid":false,"given":"Fabian","family":"Heinrich","sequence":"first","affiliation":[{"name":"Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0721-9027","authenticated-orcid":false,"given":"Kevin","family":"Roedl","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0480-2089","authenticated-orcid":false,"given":"Dominik","family":"Jarczak","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna-Lisa","family":"Goebels","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Heinemann","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine, Marien Hospital, 22087 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Department of Pneumonology and Intensive Care Medicine, Weaning Center, Asklepios Hospital Barmbek, 22307 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bachmann","sequence":"additional","affiliation":[{"name":"Department of Intensive Care and Respiratory Medicine, Clinic for Airway, Thorax and Respiratory Medicine, Asklepios Hospital Harburg, 21075 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold","family":"Bein","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Medicine, Asklepios Hospital St. Georg, 20099 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Friedrich","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care and Emergency Medicine, Asklepios Hospital Wandsbek, 22043 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Sydow","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Albertinen Hospital, 22457 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0265-8642","authenticated-orcid":false,"given":"Marc","family":"Bota","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bethesda Hospital Bergedorf, 21029 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Richard","family":"Paschen","sequence":"additional","affiliation":[{"name":"Department for Anesthesiology and Intensive Care Medicine, Amalie Sieveking Hospital, 22359 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"de Weerth","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Agaplesion Diakonie Hospital Hamburg, 20259 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Veit","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Intensive Care Medicine, Bundeswehr Hospital, 22049 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Detsch","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Medicine, Asklepios Hospital Nord, 22417 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp-Alexander","family":"Brand","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Helios Mariahilf Hospital, 21075 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Kluge","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Ondruschka","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4334-7640","authenticated-orcid":false,"given":"Dominic","family":"Wichmann","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"ref_1","unstructured":"WHO (2022, January 03). 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