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High prevalence of occult thrombosis in cases of mild/moderate COVID-19

Budong Chen1, Chunguo Jiang2, Bing Han3

  • 1The Radiology Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|December 22, 2020
PubMed
Abstract

Insights

Mild/moderate COVID-19 significantly increases the risk of venous thromboembolism (VTE), with 82.6% of patients developing thrombosis. Computed tomography venography (CTV) is crucial for detecting this thrombosis in COVID-19 patients.

Area of Science:

  • Medical research
  • Cardiovascular science
  • Infectious disease

Background:

  • Thrombosis is frequently observed in severe COVID-19 cases.
  • Limited data exists on thromboembolism incidence in mild/moderate COVID-19.
  • Normal coagulation tests do not exclude thrombotic risk in these patients.

Purpose of the Study:

  • To determine the incidence of thromboembolism in mild/moderate COVID-19.
  • To compare diagnostic accuracy of imaging techniques for thrombosis detection.
  • To highlight the importance of thrombotic screening in all COVID-19 cases.

Main Methods:

  • 23 patients with mild/moderate COVID-19 pneumonia underwent computed tomography pulmonary angiography (CTPA) and computed tomography venography (CTV).
  • Doppler ultrasound (DUS) was used for initial screening of extremity veins.
  • Analysis included incidence, clinical, laboratory, imaging features, and prognosis of venous thromboembolism (VTE).

Main Results:

  • A high incidence of VTE (82.6%, 19/23 patients) was detected, primarily distal limb thrombosis.
  • Doppler ultrasound (DUS) showed low sensitivity, with only one VTE patient testing positive.
  • Computed tomography venography (CTV) identified thrombosis in all affected patients, despite normal coagulation parameters (except WBC and LDH).

Conclusions:

  • Computed tomography venography (CTV) screening revealed a markedly increased incidence of thrombosis (82.6%) in mild/moderate COVID-19.
  • Screening for thrombosis is essential for all COVID-19 patients, irrespective of severity.
  • CTV demonstrates superior sensitivity over DUS for detecting thrombosis in COVID-19, warranting further research into its clinical significance.
Keywords:
COVID-19Mild/moderate COVID-19Thrombotic complicationsVenous thromboembolism

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