Medicinal, Psychological, and Health Research Journal (MPHRJ)

Prevalence of Deep Vein Thrombosis in Patients with COVID 19 Admitted to the Intensive Care Unit

Document Type : Original Article

Authors

Mansour Rezaei 1
Hamid Owaysee Osquee 2

1 Associate Professor of Anesthesiology, Department of Anesthesiology, School of Medicine, Tabriz, Iran

2 Associate Professor of Infectious Disease, Department of Infectious Disease, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

https://doi.org/10.22034/mphrj.2026.576396.1072
Abstract
Introduction: Critically ill patients with COVID 19 exhibit a pronounced hypercoagulable state, predisposing them to deep vein thrombosis during ICU admission. Inflammation driven endothelial dysfunction, hypoxia, and immobilization contribute to this elevated risk. Determining the true prevalence of DVT in this population is essential for optimizing thromboprophylaxis strategies and improving clinical outcomes.

Material and methods: This retrospective observational study evaluated critically ill patients with concurrent COVID 19 and active malignancy admitted to a tertiary ICU. Clinical records, laboratory parameters, and imaging confirmed thrombotic events were systematically analyzed. Multivariable logistic regression was applied to identify independent risk factors for vascular thrombosis, providing clinically relevant insights for risk stratification and management in this high risk population.

Results: Thrombotic complications occurred in 28.3% of critically ill ICU patients with concurrent COVID 19 and active malignancy, while 71.7% remained free of thrombosis (P < 0.001). Among affected patients, venous thromboembolism predominated, with lower extremity deep vein thrombosis and pulmonary embolism being the most frequent manifestations, whereas arterial, cerebral, and coronary events were uncommon.

Conclusion: In conclusion, thrombotic complications remain a common and clinically significant problem among ICU patients with concurrent COVID 19 and active malignancy. Venous thromboembolism predominates, and its occurrence is associated with older age, higher BMI, specific cancer types, greater comorbidity burden, prolonged ICU stay, increased need for mechanical ventilation, and higher mortality.

Graphical Abstract

Prevalence of Deep Vein Thrombosis in Patients with COVID 19 Admitted to the Intensive Care Unit

Keywords

ICU
COVID 19
thromboembolism
Subjects
[1]    Lippi, G., & Favaloro, E. J. (2020). D-dimer is associated with severity of coronavirus disease 2019: A pooled analysis. Thrombosis and Haemostasis, 120(5), 876-878.  
[2]    Tang, N., Li, D., Wang, X., & Sun, Z. (2020). Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis, 18(4), 844-847.
[3]    Llitjos, J. F., Leclerc, M., Chochois, C., Monsallier, J. M., Ramakers, M., Auvray, M., et al. (2020). High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. Journal of Thrombosis and Haemostasis, 18(7), 1743-1746.
[4]    Gazzaruso, C., Paolozzi, E., Valenti, C., Brocchetta, M., Naldani, D., Grignani, C., et al. (2020). Association between antithrombin and mortality in patients with COVID-19: A possible link with obesity. Nutrition, Metabolism and Cardiovascular Diseases, 30(11), 1914-1919.  
[5]    Marongiu, F., Grandone, E., & Barcellona, D. (2020). Pulmonary thrombosis in 2019-nCoV pneumonia? Journal of Thrombosis and Haemostasis, 18(6), 1511-1513.     
[6]    Ackermann, M., Verleden, S. E., Kuehnel, M., Haverich, A., Welte, T., Laenger, F., et al. (2020). Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. New England Journal of Medicine, 383(2), 120-128.
[7]    Gupta, N., Zhao, Y. Y., & Evans, C. E. (2019). The stimulation of thrombosis by hypoxia. Thrombosis Research, 181, 77-83.       
[8]    Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., et al. (2020). Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine, 382(18), 1708-1720.       
[9]    Grasselli, G., Zangrillo, A., Zanella, A., Antonelli, M., Cabrini, L., Castelli, A., et al. (2020). Baseline characteristics and outcomes of 1591 patients infected with SARS‑CoV‑2 admitted to ICUs of the Lombardy region, Italy. JAMA, 323(16), 1574-1581.             
[10] Poston, J. T., Patel, B. K., & Davis, A. M. (2020). Management of critically ill adults with COVID-19. JAMA, 323(18), 1839-1841.
[11] Amirfarzan, H., Cereda, M., Gaulton, T. G., Leissner, K. B., Cortegiani, A., Schumann, R., et al. (2021). Use of helmet CPAP in COVID-19: A practical review. Pulmonology, 27(5), 413-422.
[12] Ashish, A., Unsworth, A., Martindale, J., Sundar, R., Kavuri, K., Sedda, L., et al. (2020). CPAP management of COVID-19 respiratory failure: A first quantitative analysis from an inpatient service evaluation. BMJ Open Respiratory Research, 7(1), e000692.      
[13] MacIntyre, N. R. (2019). Physiologic effects of noninvasive ventilation. Respiratory Care, 64(6), 617-628.        
[14] Sakr, Y., Giovini, M., Leone, M., Pizzilli, G., Kortgen, A., Bauer, M., et al. (2020). Pulmonary embolism in patients with coronavirus disease 2019 pneumonia: A narrative review. Annals of Intensive Care, 10, 124.
[15] Righini, M., Le Gal, G., Aujesky, D., Roy, P. M., Sanchez, O., Verschuren, F., et al. (2009). Complete venous ultrasound in outpatients with suspected pulmonary embolism. Journal of Thrombosis and Haemostasis, 7(3), 406-412.
[16] Santoliquido, A., Porfidia, A., Nesci, A., De Matteis, G., Marrone, G., Porceddu, E., et al. (2020). Incidence of deep vein thrombosis among non-ICU patients hospitalized for COVID-19 despite pharmacological thromboprophylaxis. Journal of Thrombosis and Haemostasis, 18(9), 2358-2363.
[17] Demelo-Rodriguez, P., Cervilla-Munoz, E., Ordieres-Ortega, L., Parra-Virto, A., Toledano-Macias, M., Toledo-Samaniego, N., et al. (2020). Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels. Thrombosis Research, 192, 23-26.             
[18]Chang, H., Rockman, C. B., Jacobowitz, G. R., Speranza, G., Johnson, W. S., Horowitz, J. M., et al. (2020). Deep vein thrombosis in hospitalized patients with coronavirus disease 2019. Journal of Vascular Surgery: Venous and Lymphatic Disorders.   
[19] Flinterman, L. E., van der Meer, F. J. M., Rosendaal, F. R., & Doggen, C. J. M. (2008). Current perspective of venous thrombosis in the upper extremity. Journal of Thrombosis and Haemostasis, 6(8), 1262-1266.    
[20] Porfidia, A., Agostini, F., Giarretta, I., Tonello, D., Pastori, D., Pignatelli, P., et al. (2020). Upper extremity deep vein thrombosis treated with direct oral anticoagulants: A multicenter real-world experience. Journal of Thrombosis and Thrombolysis, 50(2), 355-360.       
[21] Spencer, F. A., Emery, C., Lessard, D., Goldberg, R. J., & Worcester Venous Thromboembolism Study Group. (2007). Upper extremity deep vein thrombosis: A community-based perspective. American Journal of Medicine, 120(8), 678-684.         
[22] Owens, C. A., Bui, J. T., Knuttinen, M. G., Gaba, R. C., & Carrillo, T. C. (2010). Pulmonary embolism from upper extremity deep vein thrombosis and the role of superior vena cava filters: A review of the literature. Journal of Vascular and Interventional Radiology, 21(6), 779-787.      
[23] Kucher, N. (2011). Deep-vein thrombosis of the upper extremities. New England Journal of Medicine, 364(9), 861-869. 
[24] Bleker, S. M., van Es, N., Kleinjan, A., Büller, H. R., Kamphuisen, P. W., Aggarwal, A., et al. (2016). Current management strategies and long-term clinical outcomes of upper extremity venous thrombosis. Journal of Thrombosis and Haemostasis, 14(5), 973-981.       
[25] Isma, N., Svensson, P. J., Gottsäter, A., & Lindblad, B. (2010). Upper extremity deep venous thrombosis in the population-based Malmö thrombophilia study (MATS). Thrombosis Research, 125(6), e335-e338.
[26] Ageno, W., Becattini, C., Brighton, T., Selby, R., & Kamphuisen, P. W. (2008). Cardiovascular risk factors and venous thromboembolism: A meta-analysis. Circulation, 117(1), 93-102.  
[27] Stein, P. D., Beemath, A., & Olson, R. E. (2005). Obesity as a risk factor in venous thromboembolism. American Journal of Medicine, 118(9), 978-980.      
[28] Cui, S., Chen, S., Li, X., Liu, S., & Wang, F. (2020). Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis, 18(6), 1421-1424.
[29] Helms, J., Tacquard, C., Severac, F., Leonard-Lorant, I., Ohana, M., Delabranche, X., et al. (2020). High risk of thrombosis in patients with severe SARS-CoV-2 infection: A multicenter prospective cohort study. Intensive Care Medicine, 46(6), 1089-1098.       
[30] Voicu, S., Ketfi, C., Stepanian, A., Counterman, B. G., Mohamedi, N., Siguret, V., et al. (2020). Pathophysiological processes underlying the high prevalence of deep vein thrombosis in critically ill COVID-19 patients. Frontiers in Physiology, 11, 608788.       
[31] Ibrahim, E. H., Iregui, M., Prentice, D., Sherman, G., Kollef, M. H., & Shannon, W. (2002). Deep vein thrombosis during prolonged mechanical ventilation despite prophylaxis. Critical Care Medicine, 30(4), 771-774.             
Medicinal, Psychological, and Health Research Journal (MPHRJ)
Volume 2, Issue 4
July and August 2026
Pages 267-275

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