Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients. Issue 1 (March 2021)

• Record Type: Journal Article
• Authors: Pozzi, Matteo; Giani, Marco; Fumagalli, Benedetta; Calabria, Mariangela; Leni, Davide; Segramora, Vittorio; Bellani, Giacomo; Foti, Giuseppe
• Is Part Of: Journal for vascular ultrasound. Volume 45:Issue 1(2021)
• Page Start: 11
• Page End: 14
• Publication Date: 2021-03
• Subjects: anticoagulants -- COVID-19 -- critical care -- ultrasonography -- Doppler -- venous thrombosis; Cardiovascular system -- Diseases -- Diagnosis -- Periodicals; Cardiovascular system -- Diseases -- Ultrasonic imaging -- Periodicals; Electronic journals; Periodicals; 616.1307543
• DOI: 10.1177/1544316720985812
• Languages: English
• ISSNs: 1544-3167

Abstract

An increased risk of deep vein thrombosis (DVT) has been reported in critical COVID-19 patients, despite adequate thromboprophylaxis, and most of DVT are probably asymptomatic. As a screening approach has been advocated, the best examination protocol is unknown. The objective of this study is to assess the role of a Complete Duplex Ultrasound (CDUS) examination in detecting DVT in a large population of COVID-19 patients admitted to intensive care unit (ICU) for respiratory failure. Single-center retrospective study of 145 COVID-19 patients admitted to ICU. DVT was assessed with a CDUS performed by experienced radiologist after ICU admission. DVT was confirmed in 38 patients (26%). Most DVT were distal to the knee (66%), while only 16% were proximal. At the time of the examination, 55% of the patients received full-dose anticoagulation, while 45% received thromboprophylaxis, and there were no differences in anticoagulation regimen between positive and negative patients. Patients with DVT had higher dimers compared with those with negative CDUS ( P < .002). The observed frequency of DVT is high despite adequate anticoagulation. A comprehensive and experienced ultrasound examination protocol can allow to recognize a large number of distal DVT otherwise missed, albeit their clinical significance is unknown.