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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.
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.
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.
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.
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