Abstract
BackgroundCOVID-19 infection has been associated with a high rate of thrombotic events, such as deep vein thrombosis (DVT) and acute pulmonary embolism (APE).MethodsThe purpose of our retrospective study was to evaluate the prevalence of asymptomatic DVT in lower limbs in critically ill COVID-19 patients (n = 23) with severe respiratory failure and high levels of D-dimer by bedside Doppler ultrasound (DU).ResultsDVT was diagnosed in 14 cases (60.87%), 5 in proximal venous territory and 9 in infrapopliteal veins. Computed Tomography Pulmonary Angiography (CTPA) was performed in six patients and all of them showed acute pulmonary embolism (APE) at segmental or subsegmental branches of pulmonary arteries. These patients (APE or DVT confirmed) were treated with therapeutic doses of anticoagulant therapy.ConclusionIn critically COVID-19 ill ICU patients with severe respiratory failure and elevated D-dimer, the incidence of asymptomatic DVT is high. We propose that DU allows detection of DVT in asymptomatic patients, adding a factor that may balance the decision to fully anticoagulate these patients.
Highlights
COVID-19 infection has been associated with a high rate of thrombotic events, such as deep vein thrombosis (DVT) and acute pulmonary embolism (APE) in patients admitted to intensive care unit (ICU) [1]
The purpose of our study was to evaluate the prevalence of asymptomatic DVT in lower limbs in critically ill COVID-19 patients with severe respiratory failure and
Doppler ultrasound (DU) was performed on all consecutive confirmed COVID-19 patients admitted to the Intensive Care Unit (ICU) with the diagnosis of severe pneumonia, who developed acute severe respiratory failure, requiring invasive mechanical ventilation and with elevated D-dimer levels > 0.5 μg/ml
Summary
COVID-19 infection has been associated with a high rate of thrombotic events, such as deep vein thrombosis (DVT) and acute pulmonary embolism (APE) in patients admitted to intensive care unit (ICU) [1].Several studies report a high risk of DVT in COVID19 critically ill patients with pneumonia despite adequate thromboprophylaxis [2] and have suggested the use of anticoagulant therapy in therapeutic range [3].The purpose of our study was to evaluate the prevalence of asymptomatic DVT in lower limbs in critically ill COVID-19 patients with severe respiratory failure and. COVID-19 infection has been associated with a high rate of thrombotic events, such as deep vein thrombosis (DVT) and acute pulmonary embolism (APE) in patients admitted to intensive care unit (ICU) [1]. Several studies report a high risk of DVT in COVID19 critically ill patients with pneumonia despite adequate thromboprophylaxis [2] and have suggested the use of anticoagulant therapy in therapeutic range [3]. The purpose of our study was to evaluate the prevalence of asymptomatic DVT in lower limbs in critically ill COVID-19 patients with severe respiratory failure and. COVID-19 infection has been associated with a high rate of thrombotic events, such as deep vein thrombosis (DVT) and acute pulmonary embolism (APE)
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