Systematic screening for a proximal DVT in COVID-19 hospitalized patients: Results of a comparative study - 06/07/21
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Highlights |
• | SARS-CoV-2 infection is associated with a prothrombotic state leading to a high risk of venous thromboembolic events. |
• | This comparative study aims to test the benefit of a systematic deep venous thrombosis (DVT) screening with pocket sized ultrasound device. |
• | We found that the rate of proximal DVT was low and not different to controls. |
• | Most of the pulmonary embolism found were isolated supporting the hypothesis of in situ arterial pulmonary thrombosis in patients with COVID-19. |
Summary |
Introduction |
The COVID-19 pandemic is associated with a high incidence of venous thromboembolism questioning the utility of a systematic screening for deep venous thrombosis (DVT) in hospitalised patients.
Methods |
In this prospective bicentric controlled study, 4-point ultrasound using a pocket device was used to screen for DVT, in patients with SARS-CoV-2 infection and controls admitted for acute medical illness not related to COVID-19 hospitalised in general ward, in order to assess the utility of a routine screening and to estimate the prevalence of VTE among those patients.
Results |
Between April and May 2020, 135 patients were screened, 69 in the COVID+ group and 66 in the control one. There was no significant difference in the rate of proximal DVT between the two groups (2.2% vs. 1.5%; P=0.52), despite the high rate of PE diagnosed among COVID-19 infected patients (10.1% vs. 1.5%, P=0.063). No isolated DVT was detected, 37.5% of PE was associated with DVT. Mortality (7.2% vs. 1.5%) was not different (P=0.21) between COVID-19 patients and controls.
Conclusion |
The systematic screening for proximal DVT was not found to be relevant among COVID-19 patients hospitalized in general ward despite the increase of VTE among this population. Further studies are needed to confirm the hypothesis of a local pulmonary thrombosis which may lead to new therapeutic targets.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19, Deep venous thrombosis, Pocket-sized ultrasound device, Screening
Plan
Vol 46 - N° 4
P. 163-170 - juillet 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.