Preventive ultrasound diagnosis of deep vein thrombosis of the lower extremities in patients with COVID-19

Raushan Rakhimzhanova 1, Agilan Ozyerman 1 * , Zhanar Kozhakhmetova 1, Doskhan Kozhakhmet 2, Meirzhan Abishev 3
More Detail
1 Department of Radiology, Astana Medical University, Nur-Sultan, Kazakhstan
2 Department of Internal Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
3 Department of Pulmonology, City Infectious Disease Center, Nur-Sultan, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 19, Issue 4, pp. 59-63. https://doi.org/10.23950/jcmk/12277
OPEN ACCESS 896 Views 765 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: The aim of the study was to determine the risk group for detecting early signs of thrombus formation in the veins of the lower extremities during preventive ultrasound examination in patients with COVID-19.
Materials and methods: The study included three groups of patients who were in intensive care units for COVID-19, of which 50 with acute venous thrombosis, 50 with venostasis in the veins of the lower extremities, and 50 patients without vein pathology, which constituted the control group. All patients were determined the level of D-dimer, fibrinogen and underwent duplex ultrasound scanning examination of the veins of the lower extremities.
Results: A close correlation was established between the presence of venous thrombosis and the levels of D-dimer and fibrinogen (2.33, 4.66, p=0.0001). According to the data obtained, in the examined patients values ​​>=2.33 µg/ml for D-dimer is a sign of thrombus formation with 87.76% sensitivity and 97% specificity. For fibrinogen values 0. ​​>=4.64 g/L are indicative of thrombus formation with 83.67% sensitivity and 83.00% specificity. The two studied parameters D-dimer (AUC area = 0.9458) and   fibrinogen (AUC area = 0.9024) were a very high-quality classifier model.
Conclusion: The results of this study make it possible to form risk groups for the development of deep vein thrombosis (DVT) and to carry out timely prevention of this pathology. In patients with COVID-19 with severe respiratory failure and elevated levels of D-dimer (more than 2.33 mg/l) and fibrinogen (more than 4.64 g/l) duplex ultrasound is indicated.
Keywords: preventive ultrasound diagnostics, COVID-19, deep vein thrombosis (DVT), thromboembolism

CITATION

Rakhimzhanova R, Ozyerman A, Kozhakhmetova Z, Kozhakhmet D, Abishev M. Preventive ultrasound diagnosis of deep vein thrombosis of the lower extremities in patients with COVID-19. J CLIN MED KAZ. 2022;19(4):59-63. https://doi.org/10.23950/jcmk/12277

REFERENCES

  • World Health Organization. Coronavirus disease 2019 (COVID19): Situation Report, 51. 2020. Available at: https://apps.who.-int/iris/handle/10665/331475. July 15, 2020
  • Lodigiani C., Iapichino G., Carenzo L., Cecconi M., Ferrazzi P., Sebastian T. et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020; 191:9-14. https://doi.org/10.1016/j.thromres.2020.04.024
  • Han H., Yang L., Liu R., Liu F., Wu K.L., Li J. et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clin Chem Lab Med. 2020. https://doi.org/10.1515/cclm-2020-0188
  • Coiteux I., Mazzolai L. Deep venous thrombosis: epidemiology, risk factors and natural history. Switzerland. Rundsch. Med. Prax. 2006; 95(12):455-459. https://doi.org/10.1024/0369-8394.95.12.455
  • Cushman M. Epidemiology and risk factors for venous thrombosis. Semi Hematol. 2007; 44(2):62-69. https://doi.org/10.1053/j.seminhematol.2007.02.004
  • Meissner M.H. The epidemiology of and risk factors for acute deep venous thrombosis. In: Gloviczki P., ed. Handbook of Venous Disorders. 3rd ed. London: Hodder Arnold, 2009; 94-104.
  • Bokarev I.N., Popova L.V. Venous thromboembolism and pulmonary embolism. M.: Med.inform. ag-in. 2005; 208.
  • Wichmann D, Sperhake JP, Lütgehetmann M, et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann Intern Med. 2020; 173:268. https://doi.org/10.7326/M20-2003
  • Cui S, Chen S, Li X, et al. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020; 18:1421. https://doi.org/10.1111/jth.14830
  • Ren B, Yan F, Deng Z et al (2020) Extremely high incidence of lower extremity deep venous thrombosis in 48 patients with severe COVID-19 in Wuhan. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.120.047407
  • Salles-Cunha S.X. Duplex ultrasound scanning for acute venous didease. In: Gloviczki P., ed. Handbook of Venous Disorders. 3rd ed. London: Hodder Arnold. 2009; 129-141.
  • Vardanyan A.V. Postoperative venous thromboembolic complications are a real danger and modern methods of prevention. Angiology and vascular surgery. 2008; 14(1):67-72.
  • Needleman, L., Cronan, J., Lilly, M., Merli, G.J., Adhikari, S., Hertzberg, B.S., et al. (2018) Ultrasound for Lower Extremity Deep Venous Thrombosis: Multidisciplinary Recommendations from the Society of Radiologists in Ultrasound Consensus Conference. Circulation. 137:1505-1515. https://doi.org/10.1161/CIRCULATIONAHA.117.030687
  • Poppiti R, Papanicolaou G, Perese S, Weaver FA. Limited B-mode venous imaging versus complete color-flow duplex venous scanning for detection of proximal deep venous thrombosis. J Vasc Surg 1995; 22:553-7. https://doi.org/10.1016/S0741-5214(95)70037-4
  • Zavyalova N.G., Zavadovskaya V.D. Ultrasound diagnosis of emergency conditions of the abdominal cavity with different localization of the pain syndrome. Bulletin of Siberian medicine. 2012;11(3):87-93. https://doi.org/10.20538/1682-0363-2012-3-87-93
  • Ignatiev I.M, Zubarev A.R, Gradusov E.G, Yupatov E.Yu., Krivosheeva N.V. (2017). Method of preventive ultrasound diagnosis of venous thrombosis. Angiology and vascular surgery. 23:35-42.
  • Ultrasound angioscanning / A. R. Zubarev, R. A. Grigoryan. - Moscow: Medicine, 1991. - 175, [1] p. : ill.; 20 cm; ISBN 5-225-01104-718.
  • Buyul A., Zefel P. SPSS: The Art of Information Processing. Analysis of statistical data and restoration of hidden patterns. SPb. DiaSoft. 2005
  • Koichubekov B.K. Biostatistics. Tutorial. Almaty. Evero. 2014
  • M. Sebuhyan, R. Mirailles, B. Crichi, C. Frere, P. Bonnin, A. Bergeron-Lafaurie, B. Denis, G. Liegeon, O. Peyrony, D. Farge, How to screen and diagnose deep venous thrombosis (DVT) in patients hospitalized for or suspected of COVID-19 infection, outside the intensive care units. JMV-Journal de Médecine Vasculaire. 2020; 45(6):334-343. https://doi.org/10.1016/j.jdmv.2020.08.002