García-Ceberino Pedro M, Faro-Míguez Naya, Beltrán-Ávila Francisco Javier, Fernández-Reyes Daniel, Gallardo-Muñoz Inmaculada, Guirao-Arrabal Emilio
Internal Medicine Department, Hospital Universitario Clínico San Cecilio, Spain.
Infectious Diseases Department, Hospital Universitario Clínico San Cecilio, Spain.
Med Clin (Engl Ed). 2021 Aug 27;157(4):172-175. doi: 10.1016/j.medcle.2021.01.013. Epub 2021 Aug 20.
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are both complications linked with COVID-19. Lower limb point-of-care clinical ultrasound (POCUS) could detect occult clots, helping decide whom to treat with anticoagulation.
To determine proximal DVT prevalence with POCUS screening among hospitalized COVID-19 patients.
PATIENTS/METHODS: Lower limb POCUS was performed in all patients admitted either to the ward or intensive care unit (ICU) between April 22nd and 30th 2020. Clinical and laboratory features, prescriptions, thrombotic complications and outcomes were assessed.
87 patients were screened, of which 26 (29.8%) either had been discharged from ICU (19.5%) or were still in critical condition (10.3%). DVT was found in 4 patients (3 femoral, 1 popliteal), of which 1 had not received low molecular weight heparin (LMWH) prophylaxis. 21 CT pulmonary angiograms were performed, being positive for PE in 5 cases (23.8%); only 2 of these patients suffered DVT.
Screening lower extremities with POCUS did not find a high rate of DVT among patients receiving LMWH-prophylaxis. However, there was a noteworthy amount of PE without DVT.
深静脉血栓形成（DVT）和肺栓塞（PE）均为与新型冠状病毒肺炎（COVID-19）相关的并发症。下肢即时床旁临床超声检查（POCUS）可检测隐匿性血栓，有助于决定哪些患者需接受抗凝治疗。
通过POCUS筛查确定住院COVID-19患者近端DVT的患病率。
患者/方法：对2020年4月22日至30日期间收入病房或重症监护病房（ICU）的所有患者进行下肢POCUS检查。评估临床和实验室特征、用药情况、血栓形成并发症及预后。
共筛查87例患者，其中26例（29.8%）已从ICU出院（19.5%）或仍处于危急状态（10.3%）。发现4例患者存在DVT（3例为股静脉血栓，1例为腘静脉血栓），其中1例未接受低分子量肝素（LMWH）预防治疗。进行了21次CT肺动脉造影，5例（23.8%）显示PE阳性；这些患者中只有2例患有DVT。
在接受LMWH预防治疗的患者中，通过POCUS筛查下肢未发现DVT的高发病率。然而，存在相当数量的无DVT的PE。
