High Prevalence of Deep Venous Thrombosis in Non-Severe COVID-19 Patients Hospitalized for a Neurovascular Disease

<b><i>Introduction:</i></b> Severe SARS-CoV-2 infection induces COVID-19 along with venous thromboembolic occurrences particularly in intensive care units. For non-severe COVID-19 patients affected by neurovascular diseases, the prevalence of deep venous thrombosis (DVT) is unknown. The aim of our study was to report data obtained after systematic Doppler ultrasound scanning (DUS) of lower limbs in such patients. <b><i>Methods:</i></b> Between March 20 and May 2, 2020, the deep venous system of 13 consecutive patients diagnosed with neurovascular diseases and non-severe COVID-19 was investigated with a systematic bedside DUS. <b><i>Results:</i></b> Thirteen patients were enrolled in the study including 9 acute ischaemic strokes, 1 occlusion of the ophthalmic artery, 1 transient ischaemic attack, 1 cerebral venous thrombosis and 1 haemorrhagic stroke. On admission, the median National Institute of Health Stroke Scale (NIHSS) score was of 6 (IQR, 0–20). During the first week after admission, and despite thromboprophylaxis, we found a prevalence of 38.5% of asymptomatic calves’ DVT (<i>n</i> = 5). One patient developed a symptomatic pulmonary embolism and 2 other patients died during hospitalization. The outcome was positive for the other patients with a discharge median NIHSS score of 1 (IQR, 0–11). <b><i>Discussion/Conclusion:</i></b> Despite thromboprophylaxis, systematic bedside DUS showed a high prevalence (38.5%) of asymptomatic DVT in non-severe COVID-19 patients suffering from a neurovascular disease. In the absence of a reliable marker of DVT, we suggest that this non-invasive investigation could be an interesting tool to monitor peripheral venous thrombotic complications in such patients.

Association of ocular diseases with schizophrenia, bipolar disorder, and major depressive disorder: a retrospective case-control, population-based study

Background Psychiatric disorders and ocular neurovascular diseases may share a similar pathophysiological route of vascular structures or neurological changes. The aim of this study is to investigate the association between ocular neurovascular diseases and the risk of major psychiatric disorders. Methods This was a retrospective case–control, population-based study including patients aged ≥20 and were diagnosed between 1997 and 2013. Ocular neurovascular diseases diagnosed between 1997 and 2006 and newly diagnosed psychiatric disorders including bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia between 2007 and 2013 were registered. Patients were propensity-score matched with control groups without psychiatric disorders in each cohort based on selected covariates. Results A total of one million sampled patients in the database were categorized based on their diagnoses; 2243 (37.4% men) were categorized into the BD group, 10,110 (35.2% men) into the MDD group, and 1623 (43.1% men) into the schizophrenia group. In the BD group, all glaucoma (OR 1.49, [1.18–1.89]), open-angle glaucoma (OR 2.08, [1.34–3.24]), and closed-angle glaucoma (OR 2.12, [1.36–3.33]) showed statistical significance of risk. In the MDD group, age-related macular degeneration (OR 1.33, [1.13–1.57]), all glaucoma (OR 1.24, [1.11–1.37]), open-angle glaucoma (OR 1.47, [1.21–1.80]), and dry eye syndrome (OR 1.22, [1.13–1.31]) were associated with a significantly higher risk. In the schizophrenia group, only all glaucoma (OR 1.47, [1.02–2.11]), glaucoma suspect (OR 1.88, [1.01–3.49]), and open-angle glaucoma (OR 2.19, [1.13–4.26]) showed statistical significance. Conclusions In this population-based study, ocular neurovascular diseases, especially glaucoma, were associated with increased risks of BD, MDD, and schizophrenia.

High prevalence of deep venous thrombosis in non-severe COVID-19 patients hospitalized for a neurovascular disease

Introduction: Severe SARS-CoV-2 infection, responsible for COVID-19, is accompanied by venous thromboembolic events particularly in intensive care unit. In non-severe COVID-19 patients affected by neurovascular diseases, the prevalence of deep venous thrombosis (DVT) is unknown. The aim of or study was to report data obtained after systematic Doppler ultrasound scanning (DUS) of lower limbs in such patients. Methods: Between March 20 and May 2, 2020, consecutive patients with neurovascular diseases with non-severe COVID-19 were investigated with a systematic bedside DUS. Results Thirteen patients were enrolled including 10 acute ischemic strokes, one transient ischemic attack, one cerebral venous thrombosis and one haemorrhagic stroke. At admission, the median National Institute of Health Stroke Scale (NIHSS) was of 6 (IQR, 0-20). We found a prevalence of 38.5% of asymptomatic calves DVT (n=5) during the first week after admission despite thromboprophylaxis. Among them, one patient had a symptomatic pulmonary embolism. Two patients died during hospitalization but the outcome was favourable in the others with a discharge median NIHSS of 1 (IQR, 0-11). Discussion/Conclusion: Despite thromboprophylaxis, systematic bedside DUS showed a high prevalence of 38.5% of DVT in non-severe COVID-19 patients with neurovascular diseases. Therefore, we suggest that this non-invasive investigation should be performed in all patients of this category.