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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

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Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients

Matteo Pozzi1, Marco Giani1,2, Benedetta Fumagalli2

  • 1ASST Monza, Italy.

Journal for Vascular Ultrasound : JVU
|March 25, 2022
PubMed

Insights

Critical COVID-19 patients show a high rate of deep vein thrombosis (DVT), even with anticoagulation. Complete duplex ultrasound (CDUS) effectively screens for these often asymptomatic DVTs in the ICU.

Area of Science:

  • Critical care medicine
  • Vascular imaging
  • Infectious diseases

Background:

  • Critical COVID-19 patients face an elevated risk of deep vein thrombosis (DVT), often asymptomatic, despite standard thromboprophylaxis.
  • The optimal screening protocol for detecting DVT in this population remains undetermined.

Purpose of the Study:

  • To evaluate the effectiveness of Complete Duplex Ultrasound (CDUS) in identifying DVT among critically ill COVID-19 patients.
  • To assess the prevalence and characteristics of DVT in intensive care unit (ICU) patients with respiratory failure due to COVID-19.

Main Methods:

  • A single-center retrospective study involving 145 COVID-19 patients admitted to the ICU.
  • DVT screening was performed using CDUS by experienced radiologists post-ICU admission.
  • Patient data on anticoagulation status and D-dimer levels were collected.

Main Results:

  • Deep vein thrombosis (DVT) was detected in 38 patients (26%), with most cases (66%) being distal (below the knee).
  • A significant proportion of patients (55%) were on full-dose anticoagulation, yet DVT was still prevalent.
  • Patients with confirmed DVT exhibited higher D-dimer levels compared to those without (P < .002).

Conclusions:

  • A high frequency of DVT exists in critically ill COVID-19 patients, even with adequate anticoagulation.
  • Comprehensive CDUS examinations are valuable for detecting numerous distal DVTs that might otherwise be missed.
  • Further research is needed to determine the clinical significance of these identified DVTs.

Keywords:
COVID-19Doppleranticoagulantscritical careultrasonographyvenous thrombosis

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