Elsevier

Thrombosis Research

Volume 192, August 2020, Pages 23-26
Thrombosis Research

Full Length Article
Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels

https://doi.org/10.1016/j.thromres.2020.05.018Get rights and content

Highlights

  • An increased risk of VTE in patients with COVID-19 pneumonia admitted to intensive care unit has been reported.

  • The most consistent hemostatic abnormalities with COVID-19 include mild thrombocytopenia and increased D-dimer levels.

  • In COVID-19 patients with high D-dimer levels, the incidence of asymptomatic DVT is similar to that described in other series.

  • Higher cut-off levels for D-dimer might be necessary for the diagnosis of DVT in COVID-19 patients.

Abstract

Aim

An increased risk of venous thromboembolism (VTE) in patients with COVID-19 pneumonia admitted to intensive care unit (ICU) has been reported. Whether COVID-19 increases the risk of VTE in non-ICU wards remains unknown. We aimed to evaluate the burden of asymptomatic deep vein thrombosis (DVT) in COVID-19 patients with elevated D-dimer levels.

Method

In this prospective study consecutive patients hospitalized in non-intensive care units with diagnosis of COVID-19 pneumonia and D-dimer > 1000 ng/ml were screened for asymptomatic DVT with complete compression doppler ultrasound (CCUS). The study was approved by the Institutional Ethics Committee.

Results

The study comprised 156 patients (65.4% male). All but three patients received standard doses of thromboprophylaxis. Median days of hospitalization until CCUS was 9 (IQR 5–17). CCUS was positive for DVT in 23 patients (14.7%), of whom only one was proximal DVT. Seven patients (4.5%) had bilateral distal DVT. Patients with DVT had higher median D-dimer levels: 4527 (IQR 1925-9144) ng/ml vs 2050 (IQR 1428-3235) ng/ml; p < 0.001. D-dimer levels > 1570 ng/ml were associated with asymptomatic DVT (OR 9.1; CI 95% 1.1–70.1). D-dimer showed an acceptable discriminative capacity (area under the ROC curve 0.72, 95% CI 0.61–0.84).

Conclusion

In patients admitted with COVID-19 pneumonia and elevated D-dimer levels, the incidence of asymptomatic DVT is similar to that described in other series. Higher cut-off levels for D-dimer might be necessary for the diagnosis of DVT in COVID-19 patients.

Keywords

COVID-19
SARS-CoV-2 infection
Venous thromboembolism
Deep vein thrombosis
D-dimer
Doppler ultrasound

Cited by (0)

The study did not receive any funding.

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