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Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients

High incidence of venous thromboembolic (VTE) events in coronavirus disease 2019 (COVID-19) patients has been reported despite pharmacologic thromboprophylaxis. We performed prospective bilateral lower extremity ultrasound evaluation of prolonged hospitalized COVID-19 ward patients from our institut...

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Autores principales: Lucijanic, Marko, Piskac Zivkovic, Nevenka, Ivic, Marija, Sedinic, Martina, Brkljacic, Boris, Mutvar, Andrea, Atic, Armin, Rudan, Diana, Barsic, Bruno, Luksic, Ivica, Kusec, Rajko, Ivanac, Gordana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614081/
https://www.ncbi.nlm.nih.gov/pubmed/34821975
http://dx.doi.org/10.1007/s00508-021-01973-1
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author Lucijanic, Marko
Piskac Zivkovic, Nevenka
Ivic, Marija
Sedinic, Martina
Brkljacic, Boris
Mutvar, Andrea
Atic, Armin
Rudan, Diana
Barsic, Bruno
Luksic, Ivica
Kusec, Rajko
Ivanac, Gordana
author_facet Lucijanic, Marko
Piskac Zivkovic, Nevenka
Ivic, Marija
Sedinic, Martina
Brkljacic, Boris
Mutvar, Andrea
Atic, Armin
Rudan, Diana
Barsic, Bruno
Luksic, Ivica
Kusec, Rajko
Ivanac, Gordana
author_sort Lucijanic, Marko
collection PubMed
description High incidence of venous thromboembolic (VTE) events in coronavirus disease 2019 (COVID-19) patients has been reported despite pharmacologic thromboprophylaxis. We performed prospective bilateral lower extremity ultrasound evaluation of prolonged hospitalized COVID-19 ward patients from our institution without clinical suspicion of deep vein thrombosis (DVT). A total of 102 patient were included in the study. All patients were receiving pharmacologic thromboprophylaxis, the majority in intermediate or therapeutic doses. Asymptomatic DVT was detected in 26/102 (25.5%) patients: 22 had distal and four had proximal DVT, six had bilateral leg involvement. Pulmonary embolism was highly prevalent (17/70, 24.3%) but similarly grouped among patients with and without asymptomatic DVT. In total 37.2% of patients included in the study were recognized as having VTE. Asymptomatic DVT events were more common in intensive care unit (ICU) survivors (60% in postmechanically ventilated ICU survivors, 21.2% in ward patients, 22% in high-flow oxygen treated patients; P = 0.031), in patients with higher modified International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) VTE risk-score (median 3 vs. 2 points with and without DVT; P = 0.021) and higher body temperature on admission (median 38.7 °C vs. 37.7 °C with and without DVT; P = 0.001). No clear associations with Padua VTE risk score, demographic and other clinical characteristics, intensity of thromboprophylaxis, severity of other COVID-19 symptoms, degree of systemic inflammation or D‑dimers on admission were found (P > 0.05 for all analyses). Systematic ultrasound assessment in prolonged hospitalized severe COVID-19 patients prior to hospital discharge is needed, especially in ICU survivors, to timely recognize and appropriately treat patients with asymptomatic DVT. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s00508-021-01973-1) contains supplementary material, which is available to authorized users.
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spelling pubmed-86140812021-11-26 Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients Lucijanic, Marko Piskac Zivkovic, Nevenka Ivic, Marija Sedinic, Martina Brkljacic, Boris Mutvar, Andrea Atic, Armin Rudan, Diana Barsic, Bruno Luksic, Ivica Kusec, Rajko Ivanac, Gordana Wien Klin Wochenschr Original Article High incidence of venous thromboembolic (VTE) events in coronavirus disease 2019 (COVID-19) patients has been reported despite pharmacologic thromboprophylaxis. We performed prospective bilateral lower extremity ultrasound evaluation of prolonged hospitalized COVID-19 ward patients from our institution without clinical suspicion of deep vein thrombosis (DVT). A total of 102 patient were included in the study. All patients were receiving pharmacologic thromboprophylaxis, the majority in intermediate or therapeutic doses. Asymptomatic DVT was detected in 26/102 (25.5%) patients: 22 had distal and four had proximal DVT, six had bilateral leg involvement. Pulmonary embolism was highly prevalent (17/70, 24.3%) but similarly grouped among patients with and without asymptomatic DVT. In total 37.2% of patients included in the study were recognized as having VTE. Asymptomatic DVT events were more common in intensive care unit (ICU) survivors (60% in postmechanically ventilated ICU survivors, 21.2% in ward patients, 22% in high-flow oxygen treated patients; P = 0.031), in patients with higher modified International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) VTE risk-score (median 3 vs. 2 points with and without DVT; P = 0.021) and higher body temperature on admission (median 38.7 °C vs. 37.7 °C with and without DVT; P = 0.001). No clear associations with Padua VTE risk score, demographic and other clinical characteristics, intensity of thromboprophylaxis, severity of other COVID-19 symptoms, degree of systemic inflammation or D‑dimers on admission were found (P > 0.05 for all analyses). Systematic ultrasound assessment in prolonged hospitalized severe COVID-19 patients prior to hospital discharge is needed, especially in ICU survivors, to timely recognize and appropriately treat patients with asymptomatic DVT. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s00508-021-01973-1) contains supplementary material, which is available to authorized users. Springer Vienna 2021-11-25 2021 /pmc/articles/PMC8614081/ /pubmed/34821975 http://dx.doi.org/10.1007/s00508-021-01973-1 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Lucijanic, Marko
Piskac Zivkovic, Nevenka
Ivic, Marija
Sedinic, Martina
Brkljacic, Boris
Mutvar, Andrea
Atic, Armin
Rudan, Diana
Barsic, Bruno
Luksic, Ivica
Kusec, Rajko
Ivanac, Gordana
Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients
title Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients
title_full Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients
title_fullStr Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients
title_full_unstemmed Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients
title_short Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients
title_sort asymptomatic deep vein thromboses in prolonged hospitalized covid-19 patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614081/
https://www.ncbi.nlm.nih.gov/pubmed/34821975
http://dx.doi.org/10.1007/s00508-021-01973-1
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