Trombose venosa profunda de membros inferiores em pacientes com covid-19
Deep vein thrombosis of lower limbs in patients with COVID-19
Orlando Adas Saliba Júnior; Ana Flávia de Jesus Alves; Camila Matarazzo; Gabriela Teixeira Gonçalves; Marcone Lima Sobreira
Resumo
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Abstract
As knowledge has accumulated, COVID-19 has come to be considered a disease of the respiratory system that can also cause multisystemic involvement. This study analyzed the prevalence of deep venous thrombosis (DVT) in the lower limbs of patients with COVID-19 by conducting an integrative review of the literature published from 2019 to 2022. The procedures involved in article selection were identification of keywords, definition of the search strategy, consultation of databases, and exclusion of duplicate articles and others that did not meet the review objectives. Exclusion of articles was based on the following exclusion criteria: articles on arterial vascular complications involving the lower limbs, laboratory experiments, cases reports describing venous and arterial complications involving other sites, and articles unrelated to the outcome of interest: DVT. A total of 284 articles were identified, 42 of which were included. There was considerable variability in the prevalence of DVT among patients with COVID-19 (range: 0.43 to 60.87%). The findings suggest that occurrence of DVT in patients with COVID-19 is associated with disease severity.
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Referências
1 Habas K, Nganwuchu C, Shahzad F, et al. Resolution of coronavirus disease 2019 (COVID-19). Expert Rev Anti Infect Ther. 2020;18(12):1201-11.
2 Kapoor S, Chand S, Dieiev V, et al. Thromboembolic events and role of point of care ultrasound in hospitalized Covid-19 patients needing intensive care unit admission. J Intensive Care Med. 2021;36(12):1483-90.
3 Kirshblum SC, DeLauter G, Eren F, et al. Screening for deep vein thrombosis in persons with COVID-19 upon admission to an inpatient rehabilitation hospital. Am J Phys Med Rehabil. 2021;100(5):419-23.
4 World Health Organization. WHO coronavirus (COVID-19) dashboard [Internet]. 2021 [citado 2022 dez 13].
5 Pereira de Godoy JM, Da Silva Russeff GJ, Hungaro Cunha C, Yuri Sato D, Franccini Del Frari Silva D, Guerreiro Godoy MF. Mortality and change in the prevalence of deep vein thrombosis associated with SARS-CoV-2 P.1 Variant. Cureus. 2022;14(7):e26668.
6 Umakanthan S, Sahu P, Ranade AV, et al. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J. 2020;96(1142):753-8. PMid:32563999.
7 Mezalek ZT, Khibri H, Ammouri W, et al. COVID-19 associated coagulopathy and thrombotic complications. Clin Appl Thromb Hemost. 2020;26:1076029620948137.
8 Yüce M, Filiztekin E, Özkaya KG. COVID-19 diagnosis: a review of current methods. Biosens Bioelectron. 2021;172:112752.
9 The Oxford Centre for Evidence-Based Medicine. COVID-19: what proportion are asymptomatic? [Internet]. 2020 [citado 2022 dez 13].
10 Samaniego F, Conte G. Infección por SARS-CoV-2. Una nueva enfermedad endotelial trombo-inflamatoria. Rev Med Chil. 2020;148(10):1467-74.
11 Páramo JA. Coagulopatía y trombosis: similitudes y diferencias entre coronavirus patogénicos. An Sist Sanit Navar. 2020;43(2):245-9.
12 García-Ceberino PM, Faro-Míguez N, Beltrán-Ávila FJ, Fernández-Reyes D, Gallardo-Muñoz I, Guirao-Arrabal E. Point of care ultrasound (POCUS) in diagnosis of proximal deep vein thrombosis among COVID-19 hospitalized patients with a high rate of low molecular weight heparin prophylaxis. Med Clin. 2021;157(4):172-5.
13 Donato H, Donato M. Etapas na condução de uma revisão sistemática. Acta Med Port. 2019;32(3):227-35.
14 Al-Abani K, Kilhamn N, Maret E, Mårtensson J. Thrombosis and bleeding after implementation of an intermediate-dose prophylactic anticoagulation protocol in ICU patients with COVID-19: a multicenter screening study. J Intensive Care Med. 2022;37(4):480-90.
15 Alfageme M, González Plaza J, Méndez S, et al. Venous Doppler ultrasound in critically Ill COVID-19 patients: game changer in anticoagulation therapy. Ultrasound J. 2020;12(1):54.
16 Avruscio G, Camporese G, Campello E, et al. COVID-19 and venous thromboembolism in intensive care or medical ward. Clin Transl Sci. 2020;13(6):1108-14.
17 Baccellieri D, Bertoglio L, Apruzzi L, et al. Incidence of deep venous thrombosis in COVID-19 hospitalized patients during the first peak of the Italian outbreak. Phlebology. 2021;36(5):375-83.
18 Chang H, Rockman CB, Jacobowitz GR, et al. Deep vein thrombosis in hospitalized patients with coronavirus disease 2019. J Vasc Surg Venous Lymphat Disord. 2021;9(3):597-604.
19 Contou D, Pajot O, Cally R, et al. Pulmonary embolism or thrombosis in ARDS COVID-19 patients: a French monocenter retrospective study. PLoS One. 2020;15(8):e0238413.
20 Cui N, Jiang C, Yang C, Zhang L, Feng X. Comparison of deep vein thrombosis risks in acute respiratory distress syndrome caused by COVID-19 and bacterial pneumonia: a retrospective cohort study. Thromb J. 2022;20(1):27.
21 De Giorgi A, Contini C, Greco S, et al. Is venous thromboembolism a predictable marker in older patients with COVID-19 infection? A single-center observational study. J Infect Dev Ctries. 2021;15(5):639-45.
22 Fathy A, Rizk A, Elnekeidy A, Gharraf HS, Abdelgawad MS, Samir A. Imaging of COVID-19 vasculopathy from head to toe: Egyptian collective experience after 2 years of the pandemic. Egypt J Radiol Nucl Med. 2022;53(1):139.
23 Fortini A, Torrigiani A, Sbaragli S, et al. COVID-19: persistence of symptoms and lung alterations after 3-6 months from hospital discharge. Infection. 2021;49(5):1007-15.
24 Gibson CJ, Alqunaibit D, Smith KE, et al. Probative value of the D-dimer assay for diagnosis of deep venous thrombosis in the coronavirus disease 2019 syndrome. Crit Care Med. 2020;48(12):e1322-6.
25 Greco S, Zenunaj G, Bonsi B, et al. SARS-CoV-2 and finding of vein thrombosis: can IMPROVE and IMPROVEDD scores predict COVID-19 outcomes? Eur Rev Med Pharmacol Sci. 2021;25(4):2123-30.
26 Hamadé A, Jambert L, Tousch J, et al. Systematic duplex ultrasound screening in conventional units for COVID-19 patients with follow-up of 5 days. J Vasc Surg Venous Lymphat Disord. 2021;9(4):853-8.
27 Ho JW, Chao CL, Helenowski IB, et al. Efficacy and safety of sonographer discretion to terminate a venous duplex ultrasound for diagnosis of deep vein thrombosis in coronavirus disease 2019 patients. J Vasc Surg Venous Lymphat Disord. 2023;11(1):10-18.e1.
28 Hunter M, Lurbet MF, Parodi J, et al. Deep venous thrombosis incidence in patients with COVID-19 acute respiratory distress syndrome, under intermediate dose of chemical thromboprophylaxis. Medicina. 2022;82(2):181-4. PMid:35417380.
29 Ierardi AM, Gaibazzi N, Tuttolomondo D, et al. Deep vein thrombosis in COVID-19 patients in general wards: prevalence and association with clinical and laboratory variables. Radiol Med. 2021;126(5):722-8.
30 Johnson SE, Pai E, Voroba A, Chen NW, Bahl A. Examining D-dimer and empiric anti-coagulation in COVID-19-related thrombosis. Cureus. 2022;14(7):e26883.
31 Koleilat I, Galen B, Choinski K, et al. Clinical characteristics of acute lower extremity deep venous thrombosis diagnosed by duplex in patients hospitalized for coronavirus disease 2019. J Vasc Surg Venous Lymphat Disord. 2021;9(1):36-46.
32 Lapébie FX, Minville V, Ribes A, et al. Systematic screening for deep vein thrombosis in critically Ill inpatients with COVID-19: impact on the incidence of venous thromboembolism. Front Med. 2021;7:624808.
33 Longchamp A, Longchamp J, Manzocchi-Besson S, et al. Venous thromboembolism in critically Ill patients with COVID-19: Results of a screening study for deep vein thrombosis. Res Pract Thromb Haemost. 2020;4(5):842-7.
34 Lucijanic M, Piskac Zivkovic N, Ivic M, et al. Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients. Wien Klin Wochenschr. 2021;133(23-24):1281-8.
35 Monfardini L, Morassi M, Botti P, et al. Pulmonary thromboembolism in hospitalised COVID-19 patients at moderate to high risk by Wells score: a report from Lombardy, Italy. Br J Radiol. 2020;93(1113):20200407.
36 Pancani R, Villari L, Foci V, et al. Lower limb deep vein thrombosis in COVID-19 patients admitted to intermediate care respiratory units. Thromb Res. 2021;197:44-7.
37 Paredes-Ruiz D, Gómez-Cuervo C, Gómez-Martín C, et al. Incidence of venous thromboembolism in patients with non-hematological cancer admitted for COVID-19 at a third-level hospital in Madrid. J Thromb Thrombolysis. 2022;53(2):471-8.
38 Pieralli F, Pomero F, Giampieri M, et al. Incidence of deep vein thrombosis through an ultrasound surveillance protocol in patients with COVID-19 pneumonia in non-ICU setting: a multicenter prospective study. PLoS One. 2021;16(5):e0251966.
39 Pizzi R, Gini G, Caiano L, et al. Coagulation parameters and venous thromboembolism in patients with and without COVID-19 admitted to the Emergency Department for acute respiratory insufficiency. Thromb Res. 2020;196:209-12.
40 Raj K, Chandna S, Doukas SG, et al. Combined use of wells scores and D-dimer levels for the diagnosis of deep vein thrombosis and pulmonary embolism in COVID-19: a retrospective cohort study. Cureus. 2021;13(9):e17687.
41 Ramacciotti E, Barile Agati L, Calderaro D, et al. Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial. Lancet. 2022;399(10319):50-9.
42 Ren B, Yan F, Deng Z, et al. Extremely high incidence of lower extremity deep venous thrombosis in 48 patients with severe COVID-19 in Wuhan. Circulation. 2020;142(2):181-3.
43 Rouyer O, Pierre-Paul IN, Balde AT, et al. High Prevalence of deep venous thrombosis in non-severe COVID-19 patients hospitalized for a neurovascular disease. Cerebrovasc Dis Extra. 2020;10(3):174-80.
44 Santoliquido A, Porfidia A, Nesci A, et al. Incidence of deep vein thrombosis among non-ICU patients hospitalized for COVID-19 despite pharmacological thromboprophylaxis. J Thromb Haemost. 2020;18(9):2358-63.
45 Schiaffino S, Giacomazzi F, Esseridou A, et al. Pulmonary thromboembolism in coronavirus disease 2019 patients undergoing thromboprophylaxis. Medicine. 2021;100(1):e24002.
46 Tung-Chen Y, Calderón R, Marcelo C, et al. Duplex ultrasound screening for deep and superficial vein thrombosis in COVID-19 patients. J Ultrasound Med. 2022;41(5):1095-100.
47 Voicu S, Bonnin P, Malissin I, et al. Characteristics of deep vein thrombosis in the critically ill COVID-19 patient - an observational cohort study with Doppler ultrasound measurements. Eur Rev Med Pharmacol Sci. 2022;26(2):686-94. PMid:35113444.
48 Voicu S, Delrue M, Chousterman BG, et al. Imbalance between procoagulant factors and natural coagulation inhibitors contributes to hypercoagulability in the critically ill COVID-19 patient: clinical implications. Eur Rev Med Pharmacol Sci. 2020;24(17):9161-8. PMid:32965009.
49 Wang W, Sun Q, Bao Y, et al. Analysis of risk factors for thromboembolic events in 88 patients with COVID-19 pneumonia in Wuhan, China: a retrospective descriptive report. Med Sci Monit. 2021;27:e929708.
50 Yu Y, Tu J, Lei B, et al. Incidence and risk factors of deep vein thrombosis in hospitalized COVID-19 patients. Clin Appl Thromb Hemost. 2020;26:1076029620953217.
51 Zhang L, Feng X, Zhang D, et al. Deep vein thrombosis in hospitalized patients with COVID-19 in Wuhan, China: prevalence, risk factors, and outcome. Circulation. 2020;142(2):114-28.
Submetido em:
19/04/2023
Aceito em:
13/07/2023