1. Early detection of deep vein thrombosis in patients with coronavirus disease 2019: who to screen and who not to with Doppler ultrasound?
- Author
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Antonio Arrichiello, Valentina Vespro, Valter Monzani, Anna Maria Ierardi, Flora Peyvandi, Francesco Blasi, Giacomo Grasselli, Massimo Venturini, Gianpaolo Carrafiello, Maria Carmela Andrisani, Stefano Fusco, Stefano Aliberti, Elvira Stellato, Andrea Coppola, Antonio Pesenti, Mauro Panigada, and Bhavya Rehani
- Subjects
Male ,Deep vein ,030204 cardiovascular system & hematology ,Severity of Illness Index ,law.invention ,0302 clinical medicine ,law ,Fraction of inspired oxygen ,Venous thrombosis ,030212 general & internal medicine ,Ultrasonography ,Ultrasonography, Doppler, Duplex ,Incidence ,Incidence (epidemiology) ,General Medicine ,Middle Aged ,Thrombosis ,Intensive care unit ,Intensive Care Units ,Exact test ,C-Reactive Protein ,medicine.anatomical_structure ,Radiology Nuclear Medicine and imaging ,Adult ,medicine.medical_specialty ,Critical Illness ,Doppler ,diagnosis ,Risk Assessment ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,Respiratory Rate ,Internal medicine ,Severity of illness ,medicine ,Internal Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Pandemics ,Aged ,Original Paper ,Heparin ,Interleukin-6 ,SARS-CoV-2 ,business.industry ,COVID-19 ,medicine.disease ,Oxygen ,Early Diagnosis ,nervous system ,Ferritins ,business - Abstract
BACKGROUND. Aim of the study is to evaluate the incidence of DVT in COVID-19 patients and its correlation with the severity of the disease and with clinical and laboratory findings.METHODS. 234 symptomatic patients with COVID-19, diagnosed according to the World Health Organization guidelines, were included in the study. The severity of the disease was classified as moderate, severe and critical. Doppler ultrasound (DUS) was performed in all patients. DUS findings, clinical, laboratory’s and therapeutic variables were investigated by contingency tables, Pearson chi square test and by Student T test and Fisher's exact test. ROC curve analysis was applied to study significant continuous variables.RESULTS. Overall incidence of DVT was 10.7% (25/234): 1.6% (1/60) among moderate cases, 13.8% (24/174) in severely and critically ill patients. Prolonged bedrest and intensive care unit admission were significantly associated with the presence of DVT (19.7%). Fraction of inspired oxygen, P/F ratio, respiratory rate, heparin administration, D-dimer, IL-6, ferritin and CRP showed correlation with DVT. CONCLUSIONS. DUS may be considered a useful and valid tool for early identification of DVT. In less severely affected patients, DUS as screening of DVT might be unnecessary. High rate of DVT found in severe patients and its correlation with respiratory parameters and some significant laboratory findings suggests that these can be used as a screening tool for patients who should be getting DUS.
- Published
- 2020
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