1. Systematic duplex ultrasound screening in conventional units for COVID-19 patients with follow-up of 5 days
- Author
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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, and Dominique Stephan
- Subjects
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 - Abstract
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.
- Published
- 2021