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Abstract
PurposeAim of the study is to evaluate the incidence of DVT in COVID-19 patients and its correlation with the severity of the disease and with clinical and laboratory findings.Methods234 symptomatic patients with COVID-19, diagnosed according to the World Health Organization guidelines, were included in the study. The severity of the disease was classified as moderate, severe and critical. Doppler ultrasound (DUS) was performed in all patients. DUS findings, clinical, laboratory’s and therapeutic variables were investigated by contingency tables, Pearson chi square test and by Student t test and Fisher's exact test. ROC curve analysis was applied to study significant continuous variables.ResultsOverall incidence of DVT was 10.7% (25/234): 1.6% (1/60) among moderate cases, 13.8% (24/174) in severely and critically ill patients. Prolonged bedrest and intensive care unit admission were significantly associated with the presence of DVT (19.7%). Fraction of inspired oxygen, P/F ratio, respiratory rate, heparin administration, D-dimer, IL-6, ferritin and CRP showed correlation with DVT.ConclusionDUS may be considered a useful and valid tool for early identification of DVT. In less severely affected patients, DUS as screening of DVT might be unnecessary. High rate of DVT found in severe patients and its correlation with respiratory parameters and some significant laboratory findings suggests that these can be used as a screening tool for patients who should be getting DUS.
Highlights
Clinical observations stemming from patients admitted to intensive care units (ICU) showed that several patients have signs of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) [5, 6]
These patients underwent a series of investigations, including clinical examinations, laboratory tests, chest X-ray (CXR), sometimes computed tomography (CT), and real-time reverse transcriptase polymerase chain reaction for SARS-CoV-2
The severity of the disease of the hospitalized patients was judged according to the Seventh Revised Edition of the “The diagnosis and treatment plan for the novel coronavirus disease” [8] in moderate, severe and critical disease, and patients were sorted in Low intensity care units (LICU), Mid-intensive Care Units (MICU) and Intensive Care Units (ICU), respectively
Summary
Deep vein thrombosis (DVT) occurred in 3.5% of intensive care unit (ICU) patients and 1.3% in hospitalized patient in medicine wards [1, 2]. Clinical observations stemming from patients admitted to intensive care units (ICU) showed that several patients have signs of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) [5, 6]. The purpose of this study was to explore the incidence of DVT in COVID-19 patients and correlate it with the severity of the disease as well as with clinical and laboratory findings. A correlation between the DUS result (positive/negative) and many clinical, laboratory’s and therapeutic variables (see Table 1 for variables list) was investigated by contingency tables and Pearson chi square test for categorical variables and by Student t test and Fisher’s exact test for continuous variables. Continuous variables that showed a significant correlation were studied with ROC curve analysis
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