Venous Thromboembolism in Covid-19 ICU Patients: A Narrative Review

Aim: The purpose of this narrative review is to provide a summarized coverage of evidence-based researches reporting VTE in COVID-19 patients in the ICU. It aims to serve as a contribution to healthcare professionals in designing a comprehensive strategy in managing COVID-19 patients.

Background: SARS-CoV-2 (COVID-19) was declared a global pandemic by the WHO in March 2020, as cases continued to surge since January after its sudden outbreak in China. It commonly presents with respiratory symptoms along with a fever, however, comorbidities requiring ICU admission are documented. Several anecdotal reports of VTE amongst ICU patients have surfaced since the outbreak. There is a noticeably increased risk of what appears to be a COVID-19 induced hypercoagulable state despite prophylactic and therapeutic anticoagulation treatment, consequently emphasizing the importance of systemic screening of VTE amongst ICU patients. This calls for a high level of clinical suspicion and a low diagnostic threshold. Understanding the exact impact of VTE on COVID-19 ICU patients improves our ability to reach a timely diagnosis and initiating optimal management to potentially improve survival.

Methods: Google Scholar and Pub Med were used as sources for searching and obtaining the data, as they were critically appraised for the best evidence. The information collected was overviewed and summarized in this narrative review.

Results: After searching in the previously mentioned database, 21 articles were found, assessed, and then filtered to 11 articles in correlation with the review context. 8 full-text articles, 2 case reports, and 1 clinical investigation research were obtained overall. Even with the evidenced data, efficacy of prophylactic anticoagulants remains uncertain but is nonetheless, a practical preventive approach.

Conclusion: COVID-19 infection induces a hypercoagulable state that results in VTE amongst ICU patients. Early prophylactic and therapeutic therapy is deemed essential in the early phases. Further studies are required to develop a better understanding and hence more appropriate management.