BACKGROUND: COVID-19 infection has been associated with a high rate of thrombotic events, such as deep vein thrombosis (DVT) and acute pulmonary embolism (APE). METHODS: The 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). RESULTS: DVT 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. CONCLUSION: In 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.
BACKGROUND:COVID-19infection has been associated with a high rate of thrombotic events, such as deep vein thrombosis (DVT) and acute pulmonary embolism (APE). METHODS: The purpose of our retrospective study was to evaluate the prevalence of asymptomatic DVT in lower limbs in critically illCOVID-19patients (n = 23) with severe respiratory failure and high levels of D-dimer by bedside Doppler ultrasound (DU). RESULTS: DVT 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. CONCLUSION: In 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.
Authors: Alessandro Casini; Lorenzo Alberio; Anne Angelillo-Scherrer; Pierre Fontana; Bernhard Gerber; Lukas Graf; Inga Hegemann; Wolfgang Korte; Johanna Kremer Hovinga; Thomas Lecompte; Maria Martinez; Michael Nagler; Jan-Dirk Studt; Dimitrios Tsakiris; Walter Wuillemin; Lars Asmis Journal: Swiss Med Wkly Date: 2020-04-11 Impact factor: 2.193
Authors: Tobias Tritschler; Marie-Eve Mathieu; Leslie Skeith; Marc Rodger; Saskia Middeldorp; Timothy Brighton; Per Morten Sandset; Susan R Kahn; Derek C Angus; Marc Blondon; Marc J Bonten; Marco Cattaneo; Mary Cushman; Lennie P G Derde; Maria T DeSancho; Jean-Luc Diehl; Ewan Goligher; Bernd Jilma; Peter Jüni; Patrick R Lawler; Marco Marietta; John C Marshall; Colin McArthur; Carlos Henrique Miranda; Tristan Mirault; Nuccia Morici; Usha Perepu; Christian Schörgenhofer; Michelle Sholzberg; Alex C Spyropoulos; Steve A Webb; Ryan Zarychanski; Stéphane Zuily; Grégoire Le Gal Journal: J Thromb Haemost Date: 2020-10-01 Impact factor: 5.824
Authors: Sharon E Fox; Aibek Akmatbekov; Jack L Harbert; Guang Li; J Quincy Brown; Richard S Vander Heide Journal: Lancet Respir Med Date: 2020-05-27 Impact factor: 30.700
Authors: L F van Dam; L J M Kroft; L I van der Wal; S C Cannegieter; J Eikenboom; E de Jonge; M V Huisman; F A Klok Journal: Thromb Res Date: 2020-10-09 Impact factor: 3.944
Authors: Philipp Koehler; Matteo Bassetti; Arunaloke Chakrabarti; Sharon C A Chen; Arnaldo Lopes Colombo; Martin Hoenigl; Nikolay Klimko; Cornelia Lass-Flörl; Rita O Oladele; Donald C Vinh; Li-Ping Zhu; Boris Böll; Roger Brüggemann; Jean-Pierre Gangneux; John R Perfect; Thomas F Patterson; Thorsten Persigehl; Jacques F Meis; Luis Ostrosky-Zeichner; P Lewis White; Paul E Verweij; Oliver A Cornely Journal: Lancet Infect Dis Date: 2020-12-14 Impact factor: 25.071