Impact of a clinical pharmacist in ultrasound-guided venous thromboembolism screening in hospitalized COVID-19 patients: a pilot prospective study.

Abstract

Background: The recognition, prevention and treatment of venous thromboembolism (VTE) remains a major challenge in the face of the recent SARS-COV-2 pandemic which has been associated with significant cardiovascular, renal, respiratory and hematologic complications related to hypercoagulability. There has been little literature thus far on the utility of screening ultrasound and role of the clinical pharmacist in treating these patients.Methods: We present a prospective pilot program of thirty-one consecutive SARS-CoV-2 patients who were provided four extremity screening ultrasounds for VTE on admission. This was coordinated by a clinical pharmacist as part of a multidisciplinary approach. Quantitative and qualitative data were recorded with the goal of describing the utility of the clinical pharmacist in ultrasound screening. Data collected include: demographics, information on clinical symptoms or signs at presentation, and laboratory and radiologic results during the hospitalization from each individual electronic medical record.Results: Nine of the thirty-one patients presented with venous thrombosis. Of the nine patients, there were twenty-two total clotted vessels, all of which were asymptomatic. The clinical pharmacist, as the coordinator for a multidisciplinary COVID-19 associated coagulopathy management team, drafted a screening and treatment protocol for anticoagulation prophylaxis and therapy of VTE after ultrasound findings.Conclusion: VTE screening of hospitalized SARS-CoV-2 patients reveals a significant number of asymptomatic VTEs and justifies diagnostic, prophylactic, and treatment measures coordinated by a clinical pharmacist.