Systematic duplex ultrasound screening in conventional units for COVID-19 patients with follow-up of 5 days

Autor: Michèle Lehn-Hogg, Pierre Michel, Jonathan Tousch, Lucas Jambert, Naouel Bensalah, Marjolaine Talbot, Amer Hamadé, Laurent Jacquemin, Benjamin Dervieux, Golnaz Obringer, Nathalie Buschenrieder, Olivier Hinschberger, Tarek El Nazer, Bastien Woehl, Dominique Stephan
Rok vydání: 2021
Předmět:
Male
Computed Tomography Angiography
RT-: PCR
transcriptase polymerase chain reaction
030204 cardiovascular system & hematology
Body Mass Index
law.invention
VTE
Venous thromboembolisms
D
Day
COVID-19 Testing
0302 clinical medicine
law
AF
Atrial fibrillation
030212 general & internal medicine
Lung
Venous Thrombosis
Ultrasonography
Doppler
Duplex
CTPA
Computer tomography pulmonary angiogram
Ultrasound
Heparin
Middle Aged
Thrombosis
Intensive care unit
Pulmonary embolism
ICU
Intensive care unit
Venous thrombosis
C-Reactive Protein
Lower Extremity
CRP
C-reactive protein
DOACs
Direct oral anticoagulant
CT
Computed tomography
Female
Radiology
Cardiology and Cardiovascular Medicine
medicine.drug
medicine.medical_specialty
BMI
Body mass index
PE
Pulmonary embolism
DVT
Deep venous thrombosis
Article
Fibrin Fibrinogen Degradation Products
03 medical and health sciences
medicine
Coagulopathy
Duplex ultrasound
Humans
CMV
Cytomegalovirus
deep venous thrombosis
Aged
Retrospective Studies
SARS-CoV-2
business.industry
COVID-19
Anticoagulants
GFR
Glomerular filtration rate
medicine.disease
DU
Duplex ultrasound
LMWH
Low molecular weight heparin
Surgery
EA
elevated aminotransferasis
business
Body mass index
Zdroj: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Journal of Vascular Surgery: Venous and Lymphatic Disorders
ISSN: 2213-333X
DOI: 10.1016/j.jvsv.2020.11.019
Popis: Objective COVID-19 patients may develop coagulopathy which is associated with poor prognosis and high risk of thrombosis. The objective of this work was to evaluate the prevalence of deep venous thrombosis of lower limbs (DVT) through ultrasonography in patients infected with COVID-19 admitted to hospital in conventional units with 5 days monitoring. The secondary objective was to determine if D-dimer levels body mass index (BMI) and C-reactive ; protein (CRP) were associated with DVT. Materials and Methods 72 patients with a mean age of 65±12.3 years infected with COVID-19 were admitted to three conventional units at our institution ,28 patients were women. A COVID-19 diagnosis was made by transcriptase polymerase chain reaction by means of nasopharyngeal swab or by chest computer tomography (CT) without iodine contrast media. Demographics ,co-morbidities characteristics and laboratory parameters were collected . A preventive anticoagulation treatment was established on admission with low molecular weight heparin (LMWH) . A complete venous duplex ultrasound (DU) test of lower limbs was performed on Day (D) 0 and D5 .A pulmonary CT angiograms with iodine contrast media (CTPA) was required when was ; suspected pulmonary embolism (PE). Results On D0 the DU showed acute DVT in seven patients (9.75%).A CTPA was performed in 12 patients (16.65%) ,3 of whom with an acute PE (25 %). On D0 acute DVT was not significantly associated with CRP (mean 101±98.6 in the group without DVT versus 67.6±58.4 mg/l p=0.43) or BMI ( 27.7 ±5.04 versus 28.1 ± 2.65 Kg/m2 p=0.54 ).However we found a significant association between acute DVT and D-dimer levels (1536±2347 versus 9652 ±10205 ng/ml p
In 72 patients admitted to standard hospital wards with COVID-19 pneumonia screening duplex ultrasound (DU) found 9.7% had DVT on admission and 15.6% without DVT on admission had and examined with DU on day 5 had developed DVT despite preventative anticoagulation justifying DU screening in non-ICU hospitalized patients with COVID-19 pneumonia.
Databáze: OpenAIRE
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