Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels

Abstract

An increased risk of venous thromboembolism (VTE) in patients with COVID-19 pneumonia admitted to intensive care unit (ICU) has been reported. Whether COVID-19 increases the risk of VTE in non-ICU wards remains unknown. We aimed to evaluate the burden of asymptomatic deep vein thrombosis (DVT) in COVID-19 patients with elevated D-dimer levels. Method: In this prospective study consecutive patients hospitalized in non-intensive care units with diagnosis of COVID-19 pneumonia and D-dimer > 1000 ng/ml were screened for asymptomatic DVT with complete compression doppler ultrasound (CCUS). The study was approved by the Institutional Ethics Committee. Results: The study comprised 156 patients (65.4% male). All but three patients received standard doses of thromboprophylaxis. Median days of hospitalization until CCUS was 9 (IQR 5-17). CCUS was positive for DVT in 23 patients (14.7%), of whom only one was proximal DVT. Seven patients (4.5%) had bilateral distal DVT. Patients with DVT had higher median D-dimer levels: 4527 (IQR 1925-9144) ng/ml vs 2050 (IQR 1428-3235) ng/ml; p < 0.001. D-dimer levels > 1570 ng/ml were associated with asymptomatic DVT (OR 9.1; CI 95% 1.1-70.1). D-dimer showed an acceptable discriminative capacity (area under the ROC curve 0.72, 95% CI 0.61-0.84). Conclusion:In patients admitted with COVID-19 pneumonia and elevated D-dimer levels, the incidence of asymptomatic DVT is similar to that described in other series. Higher cut-off levels for D-dimer might be necessary for the diagnosis of DVT in COVID-19 patients. The aim of our study was to evaluate the burden of asymptomatic

Is COVID-19 a risk factor of DVT in orthopaedic trauma surgery? A prospective study

“…The main ndings of the present study were that D-dimer level and Troponin levels were detected higher than normal in COVID-19 positive trauma patients, although no signi cant vascular pathology could be detected in these COVID-19 positive trauma patients, as reported in the literature (19,20).…”

“…In a multicentre study of 184 patients with severe COVID-19 from the Netherlands, 28 (15.2%) VTE cases were reported and the cumulative incidence of VTE was estimated to be 27% (39). Rodriguez et al stated that 23 of 156 patients had DVT in their retrospective study and as in other series, the probability of developing DVT was high in patients with COVID-19 positivity and a high D-dimer level (19). The low incidence of DVT in the patients in the current series can be considered to be due to the initiation of antithrombotic medication and wearing antiembolic socks from the time of hospitalization, and in-bed exercise was also started immediately on hospitalization.…”

Association of Clinical and Laboratory Variables with In-Hospital Incidence of Deep Vein Thrombosis in Patients with Acute Stroke: A Retrospective Study

“…In our multiple logistic regression model, patients with pulmonary infection experienced an increased risk of DVT. A higher risky relevance of pulmonary infection with DVT was also demonstrated in other researches (14,15). A research on the psychiatric inpatients revealed that the average in-hospital incidence of DVT was up to 10%, while the DVT risk in the group with pulmonary infection was signi cantly increased (16).…”

“…Interestingly, we compared the laboratory variables in different times and found that the level of D-dimer was signi cantly higher when DVT detected than that on admission, which suggested that dynamically testing D-dimer could be a predictive method for DVT. D-dimer as a sensitive marker for thrombus formation ,was an indicator for predicting DVT in different disorders (12,15,26). In the current studies, Ddimer demonstrated a sensitivity of 85%-95% and a speci city of 25%-50% for DVT (27,28).…”

High Incidence of Venous Thromboembolism in Patients with Coronavirus Disease 2019: A Call for Improved Awareness and Prevention

“…[1,[3][4][5][6][8][9][10][11][12][13][14][15] Seven studies routinely screened VTE in every patient using lower-extremity venous ultrasound scanning, and this study group was prede ned as the "routine screening group." [16][17][18][19][20][21][22] Our primary aim was to determine the incidence of VTE in COVID-19 patients in two prede ned cohort subtypes:…”