Intubated and ventilated Covid-19 patients are at significant risk of suffering from phlebitis, that is to say the appearance of blood clots in their veins, with potentially serious consequences, according to a French study.
During the pandemic, it was observed worldwide that this disease caused by a new coronavirus could promote the formation of blood clots. But according to the authors of this new study, which deals with seriously ill patients, standard anticoagulant treatment "is probably insufficient to effectively prevent deep vein thrombosis". It is the most severe form of phlebitis, a potential source of pulmonary embolism (the clot moves and clogs the pulmonary artery).
46% had a deep vein thrombosis
This work, signed by a team from the Parisian Lariboisière hospital (AP-HP / Inserm / University of Paris), concerns 56 intubated and ventilated patients for pneumonia due to Covid-19. All received anticoagulant therapy (heparin or enoxaparin) and underwent two successive examinations (doppler) several days apart to detect phlebitis.
In total, almost half of these patients (26, or 46%) had a deep vein thrombosis, a number "very high", according to these doctors, who published their work on May 30 in the specialized journal Journal of the American College of Cardiology. Six patients developed this thrombosis between the first and second Doppler exam.
These studies show "a very high prevalence of deep venous thrombosis, a large proportion of which is potentially fatal, in intubated Covid-19 patients, despite standard anticoagulant treatment applied in prevention", concludes the study.
Other anticoagulation regimes are being evaluated
For the study authors, this underlines "the need for careful monitoring of deep vein thrombosis" in this type of patient and for "an evaluation of the benefit / risk ratio of stronger anticoagulant therapy". According to the Public Assistance-Hospitals of Paris (AP-HP), "the team is currently evaluating other anticoagulation regimes, making it possible to prevent thromboses more effectively".
In April, after 18 days in intensive care in Los Angeles, Canadian actor Nick Cordero, gravely ill of the Covid-19, had to have his right leg amputated because a permanent clot blocked the circulation of blood.
In another study, published on May 28 in the European Journal of Heart Failure, French researchers had linked phlebitis, pulmonary embolism and unexplained cardiac arrest observed outside the hospital during the epidemic.
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"A significant proportion of the victims of sudden death during the epidemic peak were probably linked to pulmonary embolism," said the AP-HP in a press release.