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.

Abstract

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. 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.