• P Demelo-Rodríguez, E Cervilla-Muñoz, L Ordieres-Ortega, A Parra-Virto, M Toledano-Macías, N Toledo-Samaniego, A García-García, I García-Fernández-Bravo, Z Ji, J de-Miguel-Diez, L A Álvarez-Sala-Walther, J Del-Toro-Cervera, and F Galeano-Valle.
• Venous Thromboembolism Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain; School of Medicine, Universidad Complutense de Madrid, Spain; Gregorio Marañón Sanitary Research Institute, Madrid, Spain.
• Thromb. Res. 2020 Aug 1; 192: 23-26.

AimAn 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.MethodIn 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.ResultsThe 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).ConclusionIn 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.Copyright © 2020 Elsevier Ltd. All rights reserved.

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