In this case series, the authors systematically assessed the presence of deep vein thrombosis among patients with severe COVID-19 in an intensive care unit (ICU) in France. They prospectively performed a venous ultrasonogram of the legs in all patients on admission to ICU and repeated the test after 48 hours if the first examination was normal. All patients received standard anticoagulant prophylaxis at hospital admission. A total of 34 consecutive patients were included in this study. COVID-19 diagnosis was confirmed with polymerase chain reaction on nasopharyngeal swabs in 26 patients (76%); 8 patients (24%) had a negative result on polymerase chain reaction but had a typical pattern of COVID-19 pneumonia on chest computed tomography scan. Mean (SD) age was 62.2 (8.6) years, and 25 patients (78%) were men. Deep vein thrombosis was found in 22 patients (65%) on the first ultrasound and in 27 patients (79%) after the second ultrasound. Eighteen patients (53%) had bilateral thrombosis, and 9 patients (26%) had proximal thrombosis. The author concluded that, in view of the high rate of deep vein thrombosis reported in the study, prognosis might be improved with early detection and prompt treatment with full anticoagulant therapy in the ICU setting in patients with COVID-19.
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