How to screen and diagnose deep venous thrombosis (DVT) in patients hospitalized for or suspected of COVID-19 infection, outside the intensive care units.
COVID-19 associated coagulopathy
COVID-19 pandemic
Doppler ultrasound
Four-points compression ultrasound
Pulmonary embolism
Venous thromboembolism
Wells score
Journal
Journal de medecine vasculaire
ISSN: 2542-4513
Titre abrégé: J Med Vasc
Pays: France
ID NLM: 101709200
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
10
08
2020
accepted:
26
08
2020
entrez:
29
11
2020
pubmed:
30
11
2020
medline:
15
12
2020
Statut:
ppublish
Résumé
The Coronavirus disease-2019 outbreak (COVID-19) has been declared a pandemic by the World Health Organization. Studies report both a severe inflammatory syndrome and a procoagulant state in severe COVID-19 cases, with an increase of venous thromboembolism, including pulmonary embolism (PE) and deep vein thrombosis (DVT). In this context, we discuss the use of doppler ultrasonography (DUS) in the screening and diagnosis of DVT in ambulatory and hospitalized patients with, or suspected of having, COVID-19, outside the intensive care unit (ICU). Non-systematic review of the literature. In patients hospitalized for or suspected of COVID-19 infection with the presence of either (a) DVT clinical symptoms, (b) a strong DVT clinical probability (Wells score>2) or (c) elevated D-dimer levels without DVT clinical symptoms and without PE on lung CT angio-scan, DVT should be investigated with DUS. In the presence of PE diagnosed clinically and/or radiologically, additional systematic DVT screening using DUS is not recommended during the COVID-19 pandemic. The use of 4-points compression DUS for DVT screen and diagnosis is the most appropriate method in this context. Systematic DUS for DVT screening in asymptomatic COVID patients is not recommended unless the patient is in the ICU. This would increase the risk of unnecessarily exposing medical staff to SARS-CoV-2 and monopolizing limited resources during this period.
Identifiants
pubmed: 33248536
pii: S2542-4513(20)30338-2
doi: 10.1016/j.jdmv.2020.08.002
pmc: PMC7473249
pii:
doi:
Substances chimiques
Biomarkers
0
Fibrin Fibrinogen Degradation Products
0
fibrin fragment D
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
334-343Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.
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