Venous Thromboembolism in Critically Ill Patients with Covid‐19: Results of a Screening Study for Deep Vein Thrombosis

Longchamp, Alban; Longchamp, Justine; Manzocchi‐Besson, Sara; Whiting, Livia; Haller, Claude; Jeanneret, Séverin; Godio, Manoelle; Garcia Martinez, Juan Jose; Bonjour, Thierry; Caillat, Mary; Maitre, Guillaume; Thaler, Julian Matthias; Pantet, Rémy; Donner, Viviane; Dumoulin, Alexis; Emonet, Stéphane; Greub, Gilbert; Friolet, Raymond; Robert‐Ebadi, Helia; Righini, Marc; Sanchez, Bienvenido; Delaloye, Julie

BACKGROUND: The rapid spread of the severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), and coronavirus disease (Covid‐19), has caused more than 3.9 millions of cases worldwide. Currently, there is great interest to assess venous thrombosis prevalence, diagnosis, prevention, and management in patients with Covid‐19. OBJECTIVES: To determine the prevalence of venous thromboembolic events (VTE) in critically ill patients with Covid‐19, using lower limbs venous ultrasonography screening. METHODS: Since March 8(th), we enrolled 25 patients, who were admitted to the intensive care unit (ICU) with confirmed SARS‐CoV‐2 infections. The presence of lower extremity deep vein thrombosis (DVT) was systematically assessed by ultrasonography, between day 5 and 10 after admission. The data reported here are those available up until May 9(th) 2020. RESULTS: The mean (±SD) age of the patients was 68±11 years, 64% were men. No patients had a history of VTE. During the ICU stay, 8 patients (32%) suffered from VTE; 6 (24%) proximal DVT, 5 (20%) pulmonary embolism. The rate of symptomatic VTE was 24%, while 8% of patients had screen‐detected DVT. Only those patients with a documented VTE received a therapeutic anticoagulant regimen. As of May 9(th), 2020; 5 patients died (20%), 2 remain in the ICU (8%), and 18 were discharged (72%). CONCLUSIONS: In critically ill patients with SARS‐CoV‐2 infections, DVT screening at day 5‐10 of admission, yielded a 32% prevalence of VTE. 75% of events occurred before screening. Earlier screening might be effective in optimizing care in ICU patients with Covid‐19.