Venous thromboembolism in critically Ill patients with COVID‐19: Results of a screening study for deep vein thrombosis

Abstract

Abstract Background The rapid spread of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), and coronavirus disease 2019 (COVID‐19), has caused more than 3.9 million cases worldwide. Currently, there is great interest to assess venous thrombosis prevalence, diagnosis, prevention, and management in patients with COVID‐19. Objectives To determine the prevalence of venous thromboembolism (VTE) in critically ill patients with COVID‐19, using lower limbs venous ultrasonography screening. Methods Beginning March 8, we enrolled 25 patients who were admitted to the intensive care unit (ICU) with confirmed SARS‐CoV‐2 infections. The presence of lower extremity deep vein thrombosis (DVT) was systematically assessed by ultrasonography between day 5 and 10 after admission. The data reported here are those available up to May 9, 2020. Results The mean (± standard deviation) age of the patients was 68 ± 11 years, and 64% were men. No patients had a history of VTE. During the ICU stay, 8 patients (32%) had a VTE; 6 (24%) a proximal DVT, and 5 (20%) a pulmonary embolism. The rate of symptomatic VTE was 24%, while 8% of patients had screen‐detected DVT. Only those patients with a documented VTE received a therapeutic anticoagulant regimen. As of May 9, 2020, 5 patients had died (20%), 2 remained in the ICU (8%), and 18 were discharged (72%). Conclusions In critically ill patients with SARS‐CoV‐2 infections, DVT screening at days 5‐10 of admission yielded a 32% prevalence of VTE. Seventy‐five percent of events occurred before screening. Earlier screening might be effective in optimizing care in ICU patients with COVID‐19.

Keywords

• COVID‐19
• pulmonary embolism
• SARS virus
• ultrasonography
• venous thrombosis