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. 2021 Mar;45(1):11-14.
doi: 10.1177/1544316720985812.

Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients

Matteo Pozzi  1 , Marco Giani  1   2 , Benedetta Fumagalli  2 , Mariangela Calabria  1 , Davide Leni  1 , Vittorio Segramora  1 , Giacomo Bellani  1   2 , Giuseppe Foti  1   2
Affiliations

Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients

Matteo Pozzi et al. J Vasc Ultrasound. 2021 Mar.

Abstract

An increased risk of deep vein thrombosis (DVT) has been reported in critical COVID-19 patients, despite adequate thromboprophylaxis, and most of DVT are probably asymptomatic. As a screening approach has been advocated, the best examination protocol is unknown. The objective of this study is to assess the role of a Complete Duplex Ultrasound (CDUS) examination in detecting DVT in a large population of COVID-19 patients admitted to intensive care unit (ICU) for respiratory failure. Single-center retrospective study of 145 COVID-19 patients admitted to ICU. DVT was assessed with a CDUS performed by experienced radiologist after ICU admission. DVT was confirmed in 38 patients (26%). Most DVT were distal to the knee (66%), while only 16% were proximal. At the time of the examination, 55% of the patients received full-dose anticoagulation, while 45% received thromboprophylaxis, and there were no differences in anticoagulation regimen between positive and negative patients. Patients with DVT had higher dimers compared with those with negative CDUS (P < .002). The observed frequency of DVT is high despite adequate anticoagulation. A comprehensive and experienced ultrasound examination protocol can allow to recognize a large number of distal DVT otherwise missed, albeit their clinical significance is unknown.

Keywords: COVID-19; Doppler; anticoagulants; critical care; ultrasonography; venous thrombosis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
CDUS exams from week 9 (starting on February 24) to week 17 (ending on April 27). (Panel A) Number of patients screened with CDUS (dark gray). (Panel B) Number of positive (dark gray, line pattern) versus negative (light gray) CDUS. Note. CDUS = Complete Duplex Ultrasound.
See this image and copyright information in PMC

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