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Updated: Oct 26, 2025
Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Duplex Ultrasound Screening for Deep and Superficial Vein Thrombosis in COVID-19 Patients
Yale Tung-Chen1,2, Ruth Calderón1,3, Cristina Marcelo1,4
1Department of Internal Medicine, Hospital de Emergencias Enfermera Isabel Zendal, Madrid, Spain.
Insights
The incidence of venous thromboembolism (VTE) in stable COVID-19 patients is nearly zero. Routine Duplex ultrasonography screening is not recommended; instead, focus on early ambulation and appropriate anticoagulation.
Area of Science:
- Medical research
- Infectious diseases
- Cardiovascular health
Background:
- Growing evidence links coronavirus disease 2019 (COVID-19) to venous thromboembolism (VTE) pathophysiology.
- Previous studies report varied incidences of VTE in COVID-19 patients.
Purpose of the Study:
- To determine the actual incidence of deep or superficial vein thrombosis in COVID-19 patients.
- To identify risk and protective factors associated with VTE in this population.
Main Methods:
- Consecutive enrollment of COVID-19 patients during hospitalization.
- Bilateral lower limb Duplex ultrasonography performed weekly until discharge and for 1-month follow-up.
Main Results:
- 233 patients enrolled; mean age 54.4 years, 47.8% female; 54.5% had comorbidities.
- Most patients were normotensive with normal saturation; 55.8% required supplementary oxygen.
- Only one patient (0.4%) had a chronic distal posterior tibial vein thrombosis, resulting in a near-zero incidence of acute thrombotic events.
Conclusions:
- Routine Duplex Ultrasonography screening is not indicated for stable COVID-19 patients without VTE symptoms.
- Emphasis is placed on the benefits of intermediate low molecular weight heparin (LMWH) doses and early ambulation for COVID-19 patients.
Background:
There is growing evidence regarding the venous thromboembolic (VTE) pathophysiology of coronavirus disease 2019 (COVID-19). Several studies have reported varying incidences of this disease.
Objectives:
The main purpose of this study was to determine the real incidence of deep or superficial vein thrombosis in COVID-19. The study also aimed to identify risk and protective factors for VTE.
Methods:
Patients were consecutively enrolled and assessed with a bilateral Duplex ultrasonography of lower limbs during hospitalization. The exam was repeated weekly until discharge, and then follow-up for 1 month.
Results:
Two-hundred and thirty-three patients were enrolled. Mean age was 54.4 years (SD 12.7) and 47.8% were female. About 127 patients (54.5%) had comorbidities. At enrollment, patients were normotensive and had normal saturation (95.6%-SD 1.6, with a respiratory rate of 19.1 rpm-SD 4.0), with 130 needing at least supplementary oxygen therapy (55.8%). About 147 patients (63.1%) had at least 1 Duplex ultrasonography study performed and 1.7% had 5 or more studies. One patient had a distal posterior tibial vein thrombosis, which showed signs of chronicity and was congruent with the patient history. Therefore, the incidence of thrombotic events was nearly zero.
Discussion:
Our study results suggest that performing a Duplex Ultrasonography screening protocol in stable COVID-19 patient populations, who may need hospitalization but are without symptoms of vein thrombosis, is not founded. We presumably emphasize the advantage of using intermediate LMWH doses as well as early walking in COVID-19 patients.
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