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Inicio Medicina Clínica (English Edition) Point of care ultrasound (POCUS) in diagnosis of proximal deep vein thrombosis a...
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Vol. 157. Issue 4.
Pages 172-175 (August 2021)
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Vol. 157. Issue 4.
Pages 172-175 (August 2021)
Brief report
Point of care ultrasound (POCUS) in diagnosis of proximal deep vein thrombosis among COVID-19 hospitalized patients with a high rate of low molecular weight heparin prophylaxis
Ecografía en el punto de atención (POCUS) en el diagnóstico de trombosis venosa profunda en pacientes hospitalizados con COVID-19 en profilaxis con heparina de bajo peso molecular
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Pedro M. García-Ceberinoa,
Corresponding author
pedrogarcebe@hotmail.com

Corresponding author.
, Naya Faro-Míguezb, Francisco Javier Beltrán-Ávilaa, Daniel Fernández-Reyesa, Inmaculada Gallardo-Muñozc, Emilio Guirao-Arrabalb
a Internal Medicine Department, Hospital Universitario Clínico San Cecilio, Spain
b Infectious Diseases Department, Hospital Universitario Clínico San Cecilio, Spain
c Radiology Department, Hospital Universitario Clínico San Cecilio, Spain
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Tables (3)
Table 1. Baseline and clinical characteristics of patients (n=87).
Table 2. Radiological findings with POCUS or CTPA and complications during hospitalization.
Table 3. Clinical characteristics according to venous thrombosis findings.
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Abstract
Background

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.

Objectives

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.

Results

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.

Conclusions

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.

Keywords:
COVID-19
Deep vein thrombosis
Low-molecular-weight heparin
Pulmonary embolism
Ultrasonography
Resumen
Antecedentes

La trombosis venosa profunda (TVP) y la embolia pulmonar (EP) son complicaciones relacionadas con la COVID-19. La ecografía clínica en el punto de atención (POCUS) de las extremidades inferiores podría detectar coágulos ocultos, ayudando a decidir a quién tratar con anticoagulación.

Objetivos

Determinar la prevalencia de la TVP proximal con el cribado mediante POCUS entre los pacientes hospitalizados por COVID-19.

Pacientes/métodos

Se realizó una POCUS de miembros inferiores a todos los pacientes ingresados en planta o en la Unidad de Cuidados Intensivos (UCI) entre el 22 y el 30 de abril de 2020. Se evaluaron las características clínicas y de laboratorio, las prescripciones, las complicaciones trombóticas y los resultados.

Resultados

Se examinaron 87 pacientes, de los cuales 26 (29,8%) habían sido dados de alta de la UCI (19,5%) o seguían en estado crítico (10,3%). Se detectó una TVP en cuatro pacientes (tres femoral, uno poplítea), de los cuales uno no había recibido profilaxis con heparina de bajo peso molecular (HBPM). Se realizaron 21 angiografías pulmonares por TC, siendo positivas para EP en cinco casos (23,8%); solo dos de estos pacientes sufrieron TVP.

Conclusiones

El cribado de las extremidades inferiores con POCUS no encontró una tasa elevada de TVP entre los pacientes que recibían profilaxis con HBPM. Sin embargo, hubo una cantidad notable de EP sin TVP.

Palabras clave:
COVID-19
Trombosis venosa profunda
Heparina de bajo peso molecular
Embolia pulmonar
Ecografía

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