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Deep Vein ThrombosisNCT05028244

Evaluation of Serial Ultrasound Screening in ICU COVID-19 Patients

A study testing venous ultrasound of lower extremity in people with Deep Vein Thrombosis and Covid19, run by Hospital Universitari Vall d'Hebron Research Institute at 1 site in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This clinical trial is designed to evaluate if the periodic screening for deep venous thrombosis by ultrasound of lower extremity in patients with intensive care unit (ICU) patients with COVID 19 impacts on mortality, ICU stay and total length of stay in the hospital, along with other outcomes. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Deep Vein Thrombosis, Covid19, COVID-19 Pneumonia
What is being tested?
venous ultrasound of lower extremity
Could I receive a placebo?
No, everyone receives an active treatment
How many people
168 participants
Where
1 siteSpain
Study dates
1 Apr 2021to 13 Dec 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • COVID 19 patients in their first 72 hours of entering ICU

Who cannot join

  • Pregnant patients
  • Not COVID 19 confirmed patients by RCP
  • Patients that are in Extracorporeal membrane oxygenation
  • Patients with previous thrombotic disease

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Hospital Universitari Vall d'Hebron

    Barcelona, 08035

Other trials in Spain

About this study

Official title: Systematic Ultrasound Screening for Lower Extremity Deep Vein Thrombosis in ICU Patients With Severe COVID-19: a Randomized Clinical Trial.

This clinical trial is designed to evaluate if the periodic screening for deep venous thrombosis by ultrasound of lower extremity in patients with intensive care unit (ICU) patients with COVID 19 impacts on mortality, ICU stay and total length of stay in the hospital, along with other outcomes.

Read the detailed description

Background: COVID-19 has a high incidence of venous thromboembolic disease (VTE), especially pulmonary thromboembolism (PE) and deep vein thrombosis (DVT), with an even higher incidence in patients admitted to the intensive care unit (ICU). The presentation of these events is related to an increase in mortality and the mean stay in the ICU. The impact of systematic screening for asymptomatic lower extremity DVT in these patients has not been studied, so we propose to carry out a clinical trial to assess its impact in these patients.

Hypothesis: Serial DVT screening in patients admitted to the ICU for COVID-19 does not improve survival, mean stay, or the incidence of symptomatic VTE.

Objective: To study whether DVT screening in these patients has an impact on the incidence of symptomatic VTE, mortality and average stay in the ICU.

Methods: Non-blind randomized clinical trial on all patients aged 18 years or older admitted to the ICU for COVID-19 with less than 72 hours elapsed since their admission to the unit. Patients with DVT or PE will be excluded at the time of recruitment (all patients will be ruled out by routine ultrasound and computed tomography angiography (CT Angiography)); Pregnant patients, patients with a previous diagnosis of DVT or PE, and patients undergoing extracorporeal membrane oxygenation (ECMO) will also be excluded. Patients will be randomized into two arms at the time of inclusion: the screened group (Group 1) and the non-screened group (Group 2). Group 1: patients who will be treated according to the usual ICU protocol and, additionally, will undergo serial ultrasounds of the lower extremities twice a week (Monday and Thursday). Group 2: they will be treated according to the usual ICU protocol and no screening examinations will be performed. Patients will be followed until discharge from the ICU or death and up to a maximum of 3 weeks. The incidence of symptomatic VTE will be assessed, as well as all-cause mortality and days of stay in the ICU. Clinical and laboratory variables will be collected from each patient for subsequent statistical analysis.

Relevance: The thrombotic complications of COVID-19 are well described, as well as their high incidence in critically ill patients. This work aims to clarify the current doubts about the need for systematic DVT screening in these patients. If our hypothesis is verified, a limited resource such as ultrasound of the lower limbs could be saved, as well as the use of the necessary protection materials and, most importantly, avoid unnecessary exposure of health personnel with the consequent risk that it represents for other professionals and patients.

Being tested
venous ultrasound of lower extremity
Keywords
covid19, pulmonary embolism, intensive care unit, deep venous thrombosis
Medical subject headings
Venous Thrombosis, COVID-19, Pulmonary Embolism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • venous ultrasound of lower extremityDiagnostic test

    Patients are explored for deep vein thrombosis in femoral-popliteal and distal veins of the legs with ultrasound compression and doppler flow evaluation

Study groups in NCT05028244
Study groupRoleWhat they receive
Intervention groupExperimentalSelected patients undergo lower extremity ultrasound for diagnosis of deep vein thrombosis 2 times per week (Mondays and Thursdays) in a period of 3 weeks (21 days) of follow up
Receives: Diagnostic Test: venous ultrasound of lower extremity
control groupNo interventionThis group only undergo the first ultrasound assessment to discard previous thrombosis not detected during hospitalisation or ambulatory

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mortality

    Patients that die in ICU during follow up

    Measured: 21 days

  2. ICU Stay

    Number of days staying in that unit during follow up

    Measured: 21 days

  3. Symptomatic deep venous thrombosis

    presence of confirmed deep vein thrombosis and presence of symptoms

    Measured: 21 days

Secondary outcomes (1)
  1. composite outcome

    a composite outcome with poor outcome factors (symptomatic DVT, bleeding, ICU stay >21 days)

    Measured: 21 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Aug 2021
  2. Study start1 Apr 2021
  3. Primary completion15 Aug 2021
  4. Study completion13 Dec 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
The selected patients undergo an ultrasound of lower extremity to discard previous thrombosis episodes. Then they are randomized to an intervention group (serial screening of deep venous thrombosis in lower extremity 2 times per week) or control group (no other exploration or interventions are made).
Masking
None (open label)
Enrolment
168 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05028244
Sponsor's protocol ID
P/R(AG)176/2021
Status last verified
Apr 2024
First submitted
30 Aug 2021
Last updated
10 Apr 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wells PS, Anderson DR, Bormanis J, Guy F, Mitchell M, Gray L, Clement C, Robinson KS, Lewandowski B. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet. 1997 Dec 20-27;350(9094):1795-8. doi: 10.1016/S0140-6736(97)08140-3.

    PubMed 9428249
  • Jenner WJ, Kanji R, Mirsadraee S, Gue YX, Price S, Prasad S, Gorog DA. Thrombotic complications in 2928 patients with COVID-19 treated in intensive care: a systematic review. J Thromb Thrombolysis. 2021 Apr;51(3):595-607. doi: 10.1007/s11239-021-02394-7. Epub 2021 Feb 14.

    PubMed 33586113
  • Mohamed MFH, Al-Shokri SD, Shunnar KM, Mohamed SF, Najim MS, Ibrahim SI, Elewa H, Abdalla LO, El-Bardissy A, Elshafei MN, Abubeker IY, Danjuma M, Dousa KM, Yassin MA. Prevalence of Venous Thromboembolism in Critically Ill COVID-19 Patients: Systematic Review and Meta-Analysis. Front Cardiovasc Med. 2021 Jan 8;7:598846. doi: 10.3389/fcvm.2020.598846. eCollection 2020.

    PubMed 33585578
  • Flumignan RL, Civile VT, Tinoco JDS, Pascoal PI, Areias LL, Matar CF, Tendal B, Trevisani VF, Atallah AN, Nakano LC. Anticoagulants for people hospitalised with COVID-19: a rapid review. Cochrane Database Syst Rev. 2022 Mar 4;3(3):CD013739. doi: 10.1002/14651858.CD013739.pub2.

    PubMed 35244208
  • Sebuhyan M, Mirailles R, Crichi B, Frere C, Bonnin P, Bergeron-Lafaurie A, Denis B, Liegeon G, Peyrony O, Farge D; Saint-Louis CORE (COVID-19 RESEARCH) group. How to screen and diagnose deep venous thrombosis (DVT) in patients hospitalized for or suspected of COVID-19 infection, outside the intensive care units. J Med Vasc. 2020 Dec;45(6):334-343. doi: 10.1016/j.jdmv.2020.08.002. Epub 2020 Sep 4.

    PubMed 33248536
  • Boonyawat K, Chantrathammachart P, Numthavaj P, Nanthatanti N, Phusanti S, Phuphuakrat A, Niparuck P, Angchaisuksiri P. Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis. Thromb J. 2020 Nov 23;18(1):34. doi: 10.1186/s12959-020-00248-5.

    PubMed 33292258
  • Jimenez D, Garcia-Sanchez A, Rali P, Muriel A, Bikdeli B, Ruiz-Artacho P, Le Mao R, Rodriguez C, Hunt BJ, Monreal M. Incidence of VTE and Bleeding Among Hospitalized Patients With Coronavirus Disease 2019: A Systematic Review and Meta-analysis. Chest. 2021 Mar;159(3):1182-1196. doi: 10.1016/j.chest.2020.11.005. Epub 2020 Nov 17.

    PubMed 33217420
  • Suh YJ, Hong H, Ohana M, Bompard F, Revel MP, Valle C, Gervaise A, Poissy J, Susen S, Hekimian G, Artifoni M, Periard D, Contou D, Delaloye J, Sanchez B, Fang C, Garzillo G, Robbie H, Yoon SH. Pulmonary Embolism and Deep Vein Thrombosis in COVID-19: A Systematic Review and Meta-Analysis. Radiology. 2021 Feb;298(2):E70-E80. doi: 10.1148/radiol.2020203557. Epub 2020 Dec 15.

    PubMed 33320063
  • Bohula EA, Berg DD, Lopes MS, Connors JM, Babar I, Barnett CF, Chaudhry SP, Chopra A, Ginete W, Ieong MH, Katz JN, Kim EY, Kuder JF, Mazza E, McLean D, Mosier JM, Moskowitz A, Murphy SA, O'Donoghue ML, Park JG, Prasad R, Ruff CT, Shahrour MN, Sinha SS, Wiviott SD, Van Diepen S, Zainea M, Baird-Zars V, Sabatine MS, Morrow DA; COVID-PACT Investigators. Anticoagulation and Antiplatelet Therapy for Prevention of Venous and Arterial Thrombotic Events in Critically Ill Patients With COVID-19: COVID-PACT. Circulation. 2022 Nov;146(18):1344-1356. doi: 10.1161/CIRCULATIONAHA.122.061533. Epub 2022 Aug 29.

    PubMed 36036760
  • Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers D, Kant KM, Kaptein FHJ, van Paassen J, Stals MAM, Huisman MV, Endeman H. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: An updated analysis. Thromb Res. 2020 Jul;191:148-150. doi: 10.1016/j.thromres.2020.04.041. Epub 2020 Apr 30.

    PubMed 32381264
  • Gil-Sala D, Riera C, Garcia-Reyes M, Rodriguez M, Marrero CE, Martinez L, Gil M, Ruiz-Rodriguez JC, Ferrer R, DE Nadal M, Suito-Alcantara MA, Llagostera S, Bellmunt-Montoya S. Mortality and bleeding complications of COVID-19 critically ill patients with venous thromboembolism. Int Angiol. 2022 Feb;41(1):1-8. doi: 10.23736/S0392-9590.21.04704-0. Epub 2021 Nov 9.

    PubMed 34751541
  • Mansory EM, Srigunapalan S, Lazo-Langner A. Venous Thromboembolism in Hospitalized Critical and Noncritical COVID-19 Patients: A Systematic Review and Meta-analysis. TH Open. 2021 Jul 6;5(3):e286-e294. doi: 10.1055/s-0041-1730967. eCollection 2021 Jul.

    PubMed 34240001
  • Xiao D, Tang F, Chen L, Gao H, Li X. Cumulative Evidence for the Association of Thrombosis and the Prognosis of COVID-19: Systematic Review and Meta-Analysis. Front Cardiovasc Med. 2022 Jan 25;8:819318. doi: 10.3389/fcvm.2021.819318. eCollection 2021.

    PubMed 35146009
  • Mazzaccaro D, Giannetta M, Fancoli F, Milani V, Modafferi A, Malacrida G, Righini P, Marrocco-Trischitta MM, Nano G. COVID and venous thrombosis: systematic review of literature. J Cardiovasc Surg (Torino). 2021 Dec;62(6):548-557. doi: 10.23736/S0021-9509.21.12022-1. Epub 2021 Sep 14.

    PubMed 34520137
  • Kollias A, Kyriakoulis KG, Lagou S, Kontopantelis E, Stergiou GS, Syrigos K. Venous thromboembolism in COVID-19: A systematic review and meta-analysis. Vasc Med. 2021 Aug;26(4):415-425. doi: 10.1177/1358863X21995566. Epub 2021 Apr 4.

    PubMed 33818197

Questions about this trial

What is this clinical trial studying?

A study testing venous ultrasound of lower extremity in people with Deep Vein Thrombosis and Covid19, run by Hospital Universitari Vall d'Hebron Research Institute at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mortality (time frame: 21 days). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05028244, which also lists 25 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Apr 2024.

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