The incidence of venous thromboembolism is high among mild/moderate COVID-19 cases.
Despite of thrombosis, tests for inflammatory, coagulation and biochemistry parameters were all in normal scope.
The conventional method by Doppler ultrasound tend to underestimate the rate of thrombosis in comparisons to CTPA + CTV method.
More and more reports had observed the thrombosis in severe COVID-19 cases. The aim of this study was to evaluate the incidence of thromboembolism in mild/ moderate COVID-19. All of the patients had normal coagulation tests and had no overt thrombotic complications. It is important to screen the thrombotic status in mild/moderate COVID-19.
From June 11 to July 8, 2020, 23 patients with mild/ moderate COVID-19 pneumonia consented to having a CTPA (CT pulmonary angiography) + CTV (CT venography) scans for the lung and extremity veins. Doppler ultrasound (DUS) was performed in all patients for screening. The incidence, clinical manifestations, laboratory examinations, imaging features and prognosis of patients with venous thromboembolism (VTE) were analyzed and compared with those COVID-19 pneumonia patients without VTE.
19 patients (82.6%) had VTE, mainly distal limb thrombosis. Only one of the VTE were screened by DUS, the other VTE were negative by DUS. All of the mild / moderate patients with VTE were screened by CTPA + CTV. The blood tests for inflammatory, coagulation and biochemistry parameters were all in normal scope except for the WBC and LDH.
With CTV screening for DVT, we found the incidence of thrombosis in mild to moderate COVID-19 patients was soared to 82.6% (19/23). Screening for thrombosis is important in COVID-19. CTV is more sensitive than the DUS in detecting thrombosis. More research is needed to evaluate the significance of thrombosis in COVID-19 pneumonia.