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2020 ; 68
(ä): 83-87
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Characteristics of Venous Thromboembolism in COVID-19 Patients: A Multicenter
Experience from Northern Italy
#MMPMID32673648
Marone EM
; Bonalumi G
; Curci R
; Arzini A
; Chierico S
; Marazzi G
; Diaco DA
; Rossini R
; Boschini S
; Rinaldi LF
Ann Vasc Surg
2020[Oct]; 68
(ä): 83-87
PMID32673648
show ga
BACKGROUND: The liability of patients affected by novel coronavirus disease
(COVID-19) to develop venous thromboembolic events is widely acknowledged.
However, many particulars of the interactions between the two diseases are still
unknown. This study aims to outline the main characteristics of deep venous
thrombosis (DVT) and pulmonary embolism (PE) in COVID-19 patients, based on the
experience of four high-volume COVID-19 hospitals in Northern Italy. METHODS: All
cases of COVID-19 in-hospital patients undergoing duplex ultrasound (DUS) for
clinically suspected DVT between March 1st and April 25th, 2020, were reviewed.
Demographics and clinical data of all patients with confirmed DVT were recorded.
Computed tomography pulmonary angiographies of the same population were also
examined looking for signs of PE. RESULTS: Of 101 DUS performed, 42 were positive
for DVT, 7 for superficial thrombophlebitis, and 24 for PE, 8 of which associated
with a DVT. Most had a moderate (43.9%) or mild (16.9%) pneumonia. All venous
districts were involved. Time of onset varied greatly, but diagnosis was more
frequent in the first two weeks since in-hospital acceptance (73.8%). Most PEs
involved the most distal pulmonary vessels, and two-thirds occurred in absence of
a recognizable DVT. CONCLUSIONS: DVT, thrombophlebitis, and PE are different
aspects of COVID-19 procoagulant activity and they can arise regardless of
severity of respiratory impairment. All venous districts can be involved,
including the pulmonary arteries, where the high number and distribution of the
thrombotic lesions without signs of DVT could hint a primitive thrombosis rather
than embolism.
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