Initial reports have indicated a higher incidence of venous thromboembolism (VTE) among patients with coronavirus disease 2019 (COVID-19) compared to other critical illnesses. Helms et al. found pulmonary embolisms in 25% of patients undergoing CT pulmonary angiography despite prophylactic or therapeutic anticoagulation.

Similarly, a 27% incidence of VTE was described by Klok et al. in critically ill COVID-19 patients despite use of standard thromboprophylaxis.

Recently, Llitjos et al. found a higher rate of VTE (69%) among severe COVID-19 patients while on anticoagulation.

We confirm a 31% incidence of VTE among patients with COVID-19 admitted to the ICU, and our group of experienced point of care ultrasound (POCUS) trained intensivists (> 5 years) noticed a striking pattern of spontaneous echo contrast (SEC) in the venous system during central line placements.

This led us to develop a protocol for lower extremity POCUS scans on all COVID-19 patients in the ICU that included optimization of the gain till no SEC was observed in the adjacent arterial lumen.

Lower extremity POCUS scan of 2-region compression ultrasonography can be carried out by intensivists rapidly and accurately.

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