Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients.

High incidence of venous thromboembolic (VTE) events in coronavirus disease 2019 (COVID-19) patients has been reported despite pharmacologic thromboprophylaxis. We performed prospective bilateral lower extremity ultrasound evaluation of prolonged hospitalized COVID-19 ward patients from our institution without clinical suspicion of deep vein thrombosis (DVT).A total of 102 patient were included in the study. All patients were receiving pharmacologic thromboprophylaxis, the majority in intermediate or therapeutic doses. Asymptomatic DVT was detected in 26/102 (25.5%) patients: 22 had distal and four had proximal DVT, six had bilateral leg involvement. Pulmonary embolism was highly prevalent (17/70, 24.3%) but similarly grouped among patients with and without asymptomatic DVT. In total 37.2% of patients included in the study were recognized as having VTE.Asymptomatic DVT events were more common in intensive care unit (ICU) survivors (60% in postmechanically ventilated ICU survivors, 21.2% in ward patients, 22% in high-flow oxygen treated patients; P = 0.031), in patients with higher modified International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) VTE risk-score (median 3 vs. 2 points with and without DVT; P = 0.021) and higher body temperature on admission (median 38.7 °C vs. 37.7 °C with and without DVT; P = 0.001). No clear associations with Padua VTE risk score, demographic and other clinical characteristics, intensity of thromboprophylaxis, severity of other COVID-19 symptoms, degree of systemic inflammation or D­dimers on admission were found (P > 0.05 for all analyses).Systematic ultrasound assessment in prolonged hospitalized severe COVID-19 patients prior to hospital discharge is needed, especially in ICU survivors, to timely recognize and appropriately treat patients with asymptomatic DVT.

Drop in Echocardiography Studies Preformed at the University Hospital Dubrava due to COVID-19 Pandemic

COVID-19 pandemic has resulted in a multidimensional strain on the health care system and to critically evaluate clinical workflows and how care is delivered, which is especially true for dedicated COVID-19 centers1 . University Hospital Dubrava has been in its entirety repurposed as the dedicated COVID-19 center for all of Central Croatia, thus closing it for all other patients over extended periods during 2020 and 2021. In this retrospective study we wanted to estimate the amount of unperformed transthoracic echocardiography (TTE) studies due to the COVID-19 pandemic at our center. We conducted a single center study using hospital electronic record system by collecting data of TTE studies for the period from 2011 to 2020. We established that the compound annual rate of growth (CARG) in that period was 12.1%, notwithstanding the expected drop in numbers during the pandemic. Taking into account the following CARG, anticipated normal numbers of TTE studies at our center for 2020 and 2021 would be 5471 and 6135 studies respectively. Therefrom we have established that there is in total a predicted burden of about 5500 unperformed TTE studies due to the COVID-19 pandemic as of March 2021 at our center. All these affected patients have either been put on waiting lists, delaying their work-up, or diverted to other echocardiography centers, increasing the local burden of work. The results of this study urge that it is of utmost importance to reinstate the TTE diagnostic facilities of our center as soon as possible, in order to work off the accumulated recess TTE studies on waiting lists. Also, every week of idling cycle due to the extended hospital lockdown generates a further anticipated deficit of 118 unperformed TTE studies in 2021 at our center alone. [ABSTRACT FROM AUTHOR] Copyright of Cardiologia Croatica is the property of Croatian Cardiac Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)