Radiology Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
Radiology Unit, Ospedale di Circolo e Fondazione Macchi, Insubria University, Varese, Italy.
J Ultrasound. 2021 Jun;24(2):165-173. doi: 10.1007/s40477-020-00515-1. Epub 2020 Aug 18.
Aim of the study is to evaluate the incidence of DVT in COVID-19 patients and its correlation with the severity of the disease and with clinical and laboratory findings.
234 symptomatic patients with COVID-19, diagnosed according to the World Health Organization guidelines, were included in the study. The severity of the disease was classified as moderate, severe and critical. Doppler ultrasound (DUS) was performed in all patients. DUS findings, clinical, laboratory's and therapeutic variables were investigated by contingency tables, Pearson chi square test and by Student t test and Fisher's exact test. ROC curve analysis was applied to study significant continuous variables.
Overall incidence of DVT was 10.7% (25/234): 1.6% (1/60) among moderate cases, 13.8% (24/174) in severely and critically ill patients. Prolonged bedrest and intensive care unit admission were significantly associated with the presence of DVT (19.7%). Fraction of inspired oxygen, P/F ratio, respiratory rate, heparin administration, D-dimer, IL-6, ferritin and CRP showed correlation with DVT.
DUS may be considered a useful and valid tool for early identification of DVT. In less severely affected patients, DUS as screening of DVT might be unnecessary. High rate of DVT found in severe patients and its correlation with respiratory parameters and some significant laboratory findings suggests that these can be used as a screening tool for patients who should be getting DUS.
本研究旨在评估 COVID-19 患者中深静脉血栓形成（DVT）的发生率及其与疾病严重程度以及临床和实验室发现的相关性。
本研究纳入了 234 例符合世界卫生组织指南诊断标准的有症状 COVID-19 患者。根据疾病严重程度将患者分为中度、重度和危重症。所有患者均行多普勒超声（DUS）检查。通过列联表、皮尔逊卡方检验以及学生 t 检验和 Fisher 确切检验，对 DUS 检查结果、临床、实验室和治疗变量进行分析。应用 ROC 曲线分析研究有显著意义的连续变量。
DVT 的总发生率为 10.7%（25/234）：中度患者中发生率为 1.6%（1/60），重度和危重症患者中发生率为 13.8%（24/174）。长时间卧床休息和入住重症监护病房与 DVT 的发生显著相关（19.7%）。吸入氧分数、氧合指数、呼吸频率、肝素治疗、D-二聚体、白细胞介素 6、铁蛋白和 C 反应蛋白与 DVT 相关。
DUS 可作为早期发现 DVT 的有用且有效的工具。在病情较轻的患者中，DUS 作为 DVT 的筛查可能不必要。在重度患者中发现 DVT 发生率较高，且与呼吸参数和一些重要的实验室发现相关，提示这些参数可用作应行 DUS 检查的患者的筛查工具。
