Preventive ultrasound diagnosis of deep vein thrombosis of the lower extremities in patients with COVID-19

Abstract

Aim: The aim of the study was to determine the risk group for detecting early signs of thrombus formation in the veins of the lower extremities during preventive ultrasound examination in patients with COVID-19. Materials and methods: The study included three groups of patients who were in intensive care units for COVID-19, of which 50 with acute venous thrombosis, 50 with venostasis in the veins of the lower extremities, and 50 patients without vein pathology, which constituted the control group. All patients were determined the level of D-dimer, fibrinogen and underwent duplex ultrasound scanning examination of the veins of the lower extremities. Results: A close correlation was established between the presence of venous thrombosis and the levels of D-dimer and fibrinogen (2.33, 4.66, p=0.0001). According to the data obtained, in the examined patients values ​​>=2.33 µg/ml for D-dimer is a sign of thrombus formation with 87.76% sensitivity and 97% specificity. For fibrinogen values 0. ​​>=4.64 g/L are indicative of thrombus formation with 83.67% sensitivity and 83.00% specificity. The two studied parameters D-dimer (AUC area = 0.9458) and fibrinogen (AUC area = 0.9024) were a very high-quality classifier model. Conclusion: The results of this study make it possible to form risk groups for the development of deep vein thrombosis (DVT) and to carry out timely prevention of this pathology. In patients with COVID-19 with severe respiratory failure and elevated levels of D-dimer (more than 2.33 mg/l) and fibrinogen (more than 4.64 g/l) duplex ultrasound is indicated.