Department of internal medicine, Rouen university hospital, 76000 Rouen, France.
Department of vascular haemostasis, Rouen university hospital, Normandie university, 76000 Rouen, France.
J Med Vasc. 2021 Jul;46(4):163-170. doi: 10.1016/j.jdmv.2021.05.003. Epub 2021 May 14.
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.
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.
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.
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.
COVID-19 大流行与静脉血栓栓塞症的高发病率相关,这使得人们质疑对住院患者进行深静脉血栓形成(DVT)系统筛查的效用。
在这项前瞻性的双中心对照研究中,使用袖珍设备进行 4 点超声检查,以筛查 SARS-CoV-2 感染患者和因与 COVID-19 无关的急性内科疾病住院的对照组患者的 DVT,以评估常规筛查的效用,并估计这些患者中 VTE 的患病率。
在 2020 年 4 月至 5 月期间,共筛查了 135 例患者,COVID+组 69 例,对照组 66 例。两组近端 DVT 的发生率无显著差异(2.2%对 1.5%;P=0.52),尽管 COVID-19 感染患者中诊断出的 PE 发生率较高(10.1%对 1.5%,P=0.063)。未检测到孤立性 DVT,PE 中有 37.5%与 DVT 相关。COVID-19 患者和对照组的死亡率(7.2%对 1.5%)无差异(P=0.21)。
尽管 COVID-19 患者的 VTE 发生率增加,但在普通病房住院的 COVID-19 患者中,系统筛查近端 DVT 并未发现具有相关性。需要进一步的研究来证实可能导致新的治疗靶点的局部肺血栓形成的假设。