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ORIGINAL ARTICLE Free access
Minerva Anestesiologica 2021 December;87(12):1330-7
DOI: 10.23736/S0375-9393.21.15510-5
Copyright © 2021 EDIZIONI MINERVA MEDICA
language: English
Prevalence and risk factors for venous thromboembolic events in critically ill patients with SARS-CoV-2 infection: a prospective observational study
Alessandro F. CHIESA 1 ✉, Marco PREVISDOMINI 1, Elisa VALENTI 1, Elisa STOIRA 1, Hans STRICKER 2, Bernhard GERBER 3, Daniela DEMUNDO 4, Luca CLIVIO 5, Alberto PAGNAMENTA 1, 6, 7
1 Department of Intensive Care Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; 2 Division of Angiology, Regional Hospital of Locarno, Locarno, Switzerland; 3 Clinic of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; 4 Imaging Institute of Southern Switzerland, Regional Hospital of Locarno, Locarno, Switzerland; 5 Division of Clinical Informatics, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; 6 Unit of Biostatistics, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; 7 Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland
BACKGROUND: The majority of prevalence studies on deep vein thrombosis (DVT) in severe COVID-19 patients are retrospective with DVT assessment based on clinical suspicion. Our aim was to prospectively and systematically estimate the occurrence of DVT in critically-ill mechanically-ventilated patients, and to identify potential risk factors for DVT occurrence and mortality.
METHODS: All patients with COVID-19 admitted to our 45 beds in the Intensive Care Unit (ICU) between March 6, 2020, and April 18, 2020, requiring invasive ventilatory support were daily screened for DVT with lower extremities and jugular veins ultrasonography. Univariate and multivariable logistic regression models were performed in order to identify predictors of DVT and mortality.
RESULTS: Seventy-six patients were included in the final analysis (56 men, mean age 67 years, median SOFA=7 points, median SAPS II=41 points, median PaO
CONCLUSIONS: A high number of critically-ill mechanically-ventilated COVID-19 patients developed a DVT. The majority of DVTs were catheter-related and occurred under intensive prophylactic anticoagulation. Routine ultrasound of the jugular veins should be suggested in this patient population, and in particular in presence of a central venous catheter.
KEY WORDS: COVID-19; Intensive care units; Jugular veins; Thrombosis; Ultrasonography