Systematic screening for a proximal DVT in COVID-19 hospitalized patients: Results of a comparative study - 09/06/21

Doi : 10.1016/j.jdmv.2021.05.003

Y. Fares ^a, Y.C. Sinzogan-Eyoum ^a, P. Billoir ^b, A. Bogaert ^a, G. Armengol ^c, K. Alexandre ^d, J. Lammens ^a, M. Grall ^a,^e, H. Levesque ^c, Y. Benhamou ^c, S. Miranda ^c,⁎
^a Department of internal medicine, Rouen university hospital, 76000 Rouen, France
^b Department of vascular haemostasis, Rouen university hospital, Normandie university, 76000 Rouen, France
^c UNIROUEN, Inserm U1096 EnVI, department of internal medicine, Rouen university hospital, Normandie university, 76000 Rouen, France
^d Department of infectious diseases, Rouen university hospital, 76000 Rouen, France
^e Department of medical intensive care unit, Rouen university hospital, 76000 Rouen, France

^⁎Corresponding author. 1, rue de Germont, 76031 Rouen, France.1, rue de GermontRouen76031France

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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.

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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.

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Keywords : COVID-19, Deep venous thrombosis, Pocket-sized ultrasound device, Screening