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. 2022 Sep;25(3):571-577.
doi: 10.1007/s40477-021-00625-4. Epub 2022 Jan 9.

Compressive ultrasound can predict early pulmonary embolism onset in COVID patients

Davide Ippolito  1   2 , Carlo Capodaglio  1   2 , Cesare Maino  3 , Rocco Corso  1   4 , Davide Leni  1   4 , Davide Fior  1   4 , Teresa Giandola  1   2 , Maria Ragusi  1   2 , Cammillo Talei Franzesi  1   2 , Davide Gandola  1   2 , Antonio Rovere  1   4 , Sandro Sironi  2   5
Affiliations

Compressive ultrasound can predict early pulmonary embolism onset in COVID patients

Davide Ippolito et al. J Ultrasound. 2022 Sep.

Abstract

Purpose: To evaluate the usefulness of compressive ultrasound (CUS) for the diagnosis of deep vein thrombosis (DVT) in patients with SARS-CoV-2-related infection.

Methods: 112 hospitalized patients with confirmed SARS-CoV-2 infection were retrospectively enrolled. CUS was performed within 2 days of admission and consisted in the assessment of the proximal and distal deep venous systems. Lack of compressibility, or direct identification of an endoluminal thrombus, were the criteria used for the diagnosis of DVT. Pulmonary embolism (PE) events were investigated at computed tomography pulmonary angiography (CTPA) within 5 days of follow-up. Logistic binary regression was computed to determine which clinical and radiological parameters were independently associated with PE onset.

Results: Overall, the incidence of DVT in our cohort was about 43%. The most common district involved was the left lower limb (68.7%) in comparison with the right one (58.3%) while the upper limbs were less frequently involved (4.2% the right one and 2.1% the left one, respectively). On both sides, the distal tract of the popliteal vein was the most common involved (50% right side and 45.8% left side). The presence of DVT in the distal tract of the right popliteal vein (OR = 2.444 95%CIs 1.084-16.624, p = 0.038), in the distal tract of the left popliteal vein (OR = 4.201 95%CIs 1.484-11.885, p = 0.007), and D-dimer values (OR = 2.122 95%CIs 1.030-5.495, p = 0.003) were independently associated with the onset on PE within 5 days.

Conclusions: CUS should be considered a useful tool to discriminate which category of patients can develop PE within 5 days from admission.

Keywords: Coronavirus; Diagnostic imaging; Embolism and thrombosis; Infections; Thrombosis; Tomography, X-Ray computed; Ultrasonography.

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Conflict of interest statement

Authors declared no conflict of interest.

Figures

Fig. 1
Fig. 1
A Grayscale ultrasound examination of common femoral vein demonstrating enlarged, non-compressible vessel, a typical example of DVT. B ColorDoppler examination of right deep and superficial femoral veins showing absent flow in the superficial branch due to extensive thrombosis
See this image and copyright information in PMC

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