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Prevalence of asymptomatic deep vein thrombosis in patients hospitalized with SARS-CoV-2 pneumonia: a cross-sectional study.
Intern Emerg Med. 2020 Nov; 15(8):1425-1433.IE

Abstract

The association between coronavirus disease 2019 (COVID-19) pneumonia and venous thrombotic disorders is still unclear. We assessed the association between COVID-19 infection-related pneumonia and proximal deep-vein thrombosis (DVT) in a cohort of patients admitted to our hospital during the European outbreak in the front line of Cremona, Lombardy. In a single-center cross-sectional study, all patients hospitalized for more than 5 days in Internal Medicine Department with confirmed COVID-19 pneumonia received 2-point compressive ultrasound assessment (CUS) of the leg vein system during a single day. Ninety-four percent of patients received enoxaparin as standard pharmacological prophylaxis for venous thromboembolism. The presence of DVT was defined as incompressibility of popliteal or common femoral vein. Out of 121 patients with COVID-19 pneumonia (mean age 71.8, 66.3% males) hospitalized on March 31st, 70 stayed in hospital for over 5 days and 66 of them underwent CUS of deep venous system of the legs. The presence of asymptomatic DVT was found in 9 patients (13.6%). No symptomatic DVT was found. Patients with DVT showed mean age = 75.7 years, mean D-dimer levels = 4.02 ng/ml and all of them received enoxaparin for thromboprophylaxis, except one. Computed tomography pulmonary angiogram confirmed pulmonary embolism in five patients. One every seven patients with COVID-19-related pneumonia, hospitalized for more than 5 days, had asymptomatic proximal DVT and half of them had confirmed PE despite standard pharmacological thromboprophylaxis. This observational study suggests the need of an active surveillance through CUS in patients hospitalized with acute SARS-COV-2 and underline the need of a more intense thromboprophylaxis.

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Publisher Full Text
ncbi.nlm.nih.gov
dx.doi.org
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Authors+Show Affiliations

Giorgi-Pierfranceschi M
Department of Internal Medicine, Hospital of Cremona, Viale Concordia 1, 26100, Cremona, Italy. magiopi65@gmail.com.
Paoletti O
Haemostasis and Thrombosis Center, Hospital of Cremona, Cremona, Italy.
Pan A
Department of Infectious Disease, Hospital of Cremona, Cremona, Italy.
De Gennaro F
Department of Internal Medicine, Hospital of Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Nardecchia AL
Department of Internal Medicine, Hospital of Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Morandini R
Haemostasis and Thrombosis Center, Hospital of Cremona, Cremona, Italy.
Dellanoce C
Haemostasis and Thrombosis Center, Hospital of Cremona, Cremona, Italy.
Lombi S
Department of Internal Medicine, Hospital of Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Tala M
Haemostasis and Thrombosis Center, Hospital of Cremona, Cremona, Italy.
Cancelli V
Haemostasis and Thrombosis Center, Hospital of Cremona, Cremona, Italy.
Zambelli S
Haemostasis and Thrombosis Center, Hospital of Cremona, Cremona, Italy.
Bosio G
Department of Pneumology, Hospital of Cremona, Cremona, Italy.
Romanini L
Department of Radiology, Hospital of Cremona, Cremona, Italy.
Testa S
Haemostasis and Thrombosis Center, Hospital of Cremona, Cremona, Italy.

MeSH

AgedAged, 80 and overAsymptomatic DiseasesCOVID-19Coronavirus InfectionsCross-Sectional StudiesFemaleHumansItalyMaleMiddle AgedPandemicsPneumoniaPneumonia, ViralPrevalenceTomography, X-Ray ComputedUltrasonographyVenous Thrombosis

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32840805

Citation

Giorgi-Pierfranceschi, Matteo, et al. "Prevalence of Asymptomatic Deep Vein Thrombosis in Patients Hospitalized With SARS-CoV-2 Pneumonia: a Cross-sectional Study." Internal and Emergency Medicine, vol. 15, no. 8, 2020, pp. 1425-1433.
Giorgi-Pierfranceschi M, Paoletti O, Pan A, et al. Prevalence of asymptomatic deep vein thrombosis in patients hospitalized with SARS-CoV-2 pneumonia: a cross-sectional study. Intern Emerg Med. 2020;15(8):1425-1433.
Giorgi-Pierfranceschi, M., Paoletti, O., Pan, A., De Gennaro, F., Nardecchia, A. L., Morandini, R., Dellanoce, C., Lombi, S., Tala, M., Cancelli, V., Zambelli, S., Bosio, G., Romanini, L., & Testa, S. (2020). Prevalence of asymptomatic deep vein thrombosis in patients hospitalized with SARS-CoV-2 pneumonia: a cross-sectional study. Internal and Emergency Medicine, 15(8), 1425-1433. https://doi.org/10.1007/s11739-020-02472-3
Giorgi-Pierfranceschi M, et al. Prevalence of Asymptomatic Deep Vein Thrombosis in Patients Hospitalized With SARS-CoV-2 Pneumonia: a Cross-sectional Study. Intern Emerg Med. 2020;15(8):1425-1433. PubMed PMID: 32840805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of asymptomatic deep vein thrombosis in patients hospitalized with SARS-CoV-2 pneumonia: a cross-sectional study. AU - Giorgi-Pierfranceschi,Matteo, AU - Paoletti,Oriana, AU - Pan,Angelo, AU - De Gennaro,Fabio, AU - Nardecchia,Anna Laura, AU - Morandini,Rossella, AU - Dellanoce,Claudia, AU - Lombi,Samuele, AU - Tala,Maurizio, AU - Cancelli,Vanessa, AU - Zambelli,Silvia, AU - Bosio,Giancarlo, AU - Romanini,Laura, AU - Testa,Sophie, Y1 - 2020/08/25/ PY - 2020/05/16/received PY - 2020/08/05/accepted PY - 2020/8/26/pubmed PY - 2020/11/25/medline PY - 2020/8/26/entrez KW - Asymptomatic deep veins thrombosis KW - Covid-19 pneumonia KW - Point of care ultrasonography KW - Prevalence SP - 1425 EP - 1433 JF - Internal and emergency medicine JO - Intern Emerg Med VL - 15 IS - 8 N2 - The association between coronavirus disease 2019 (COVID-19) pneumonia and venous thrombotic disorders is still unclear. We assessed the association between COVID-19 infection-related pneumonia and proximal deep-vein thrombosis (DVT) in a cohort of patients admitted to our hospital during the European outbreak in the front line of Cremona, Lombardy. In a single-center cross-sectional study, all patients hospitalized for more than 5 days in Internal Medicine Department with confirmed COVID-19 pneumonia received 2-point compressive ultrasound assessment (CUS) of the leg vein system during a single day. Ninety-four percent of patients received enoxaparin as standard pharmacological prophylaxis for venous thromboembolism. The presence of DVT was defined as incompressibility of popliteal or common femoral vein. Out of 121 patients with COVID-19 pneumonia (mean age 71.8, 66.3% males) hospitalized on March 31st, 70 stayed in hospital for over 5 days and 66 of them underwent CUS of deep venous system of the legs. The presence of asymptomatic DVT was found in 9 patients (13.6%). No symptomatic DVT was found. Patients with DVT showed mean age = 75.7 years, mean D-dimer levels = 4.02 ng/ml and all of them received enoxaparin for thromboprophylaxis, except one. Computed tomography pulmonary angiogram confirmed pulmonary embolism in five patients. One every seven patients with COVID-19-related pneumonia, hospitalized for more than 5 days, had asymptomatic proximal DVT and half of them had confirmed PE despite standard pharmacological thromboprophylaxis. This observational study suggests the need of an active surveillance through CUS in patients hospitalized with acute SARS-COV-2 and underline the need of a more intense thromboprophylaxis. SN - 1970-9366 UR - https://www.unboundmedicine.com/medline/citation/32840805/Prevalence_of_asymptomatic_deep_vein_thrombosis_in_patients_hospitalized_with_SARS_CoV_2_pneumonia:_a_cross_sectional_study_ L2 - https://dx.doi.org/10.1007/s11739-020-02472-3 DB - PRIME DP - Unbound Medicine ER -