Venous thromboembolism in critically III patients with COVID-19: Results of a screening study for deep vein thrombosis
Venous thromboembolism in critically III patients with COVID-19: Results of a screening study for deep vein thrombosis
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DOI：
10.1002/rth2.12376
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发表时间：
2020-06-30
影响因子：
4.6
通讯作者：
Delaloye, Julie
中科院分区：
文献类型：
--
作者：
Longchamp, Alban;Longchamp, Justine;Delaloye, Julie
背景资料：严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）和2019冠状病毒病（COVID-19）的快速传播在全球造成了390多万例病例。目前，人们对评估COVID-19患者静脉血栓形成的患病率、诊断、预防和管理非常感兴趣。目的：通过下肢静脉超声筛查，确定COVID-19危重患者静脉血栓栓塞（VTE）的患病率。方法：从3月8日开始，我们招募了25名确诊为SARS-CoV-2感染的重症监护室（ICU）患者。入院后第5 ~ 10天，通过超声检查系统评估下肢深静脉血栓形成（DVT）的存在。这里报告的数据是截至2020年5月9日的数据。结果：患者的平均（+/-标准差）年龄为68 ± 11岁，64%为男性。无患者有VTE病史。在ICU住院期间，8例患者（32%）发生了VTE; 6例（24%）发生了近端DVT，5例（20%）发生了肺栓塞。症状性VTE的发生率为24%，而8%的患者有筛查检测到的DVT。只有那些记录有VTE的患者接受了治疗性抗凝治疗方案。截至2020年5月9日，5名患者死亡（20%），2名患者仍在ICU（8%），18名患者出院（72%）。结论：在SARS-CoV-2感染的危重患者中，在入院第5-10天进行DVT筛查，VTE患病率为32%。75%的事件发生在筛选前。早期筛查可能有效地优化了ICU COVID-19患者的护理。[图形]。
Background: The rapid spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and coronavirus disease 2019 (COVID-19), has caused more than 3.9 million cases worldwide. Currently, there is great interest to assess venous thrombo-sis prevalence, diagnosis, prevention, and management in patients with COVID-19.Objectives: To determine the prevalence of venous thromboembolism (VTE) in critically ill patients with COVID-19, using lower limbs venous ultrasonography screening.Methods: Beginning March 8, 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 to May 9, 2020.Results: The mean (+/- standard deviation) age of the patients was 68 +/- 11 years, and 64% were men. No patients had a history of VTE. During the ICU stay, 8 patients (32%) had a VTE; 6 (24%) a proximal DVT, and 5 (20%) a 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, 2020, 5 patients had died (20%), 2 remained in the ICU (8%), and 18 were discharged (72%).Conclusions: In critically ill patients with SARS-CoV-2 infections, DVT screening at days 5-10 of admission yielded a 32% prevalence of VTE. Seventy-five percent of events occurred before screening. Earlier screening might be effective in optimizing care in ICU patients with COVID-19.[GRAPHICS].