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A total of adults were included from a COVID ward in this prospective multi-center study mean age All patients underwent 8-zone LUS, and all ultrasound images were analyzed off-line blinded. The median number of B-lines was 12 IQR: 8, 18 , and 44 During hospitalization, 17 patients developed VTE 4 deep-vein thrombosis, 15 pulmonary embolism , 12 following and 5 prior to LUS. These findings should be considered hypothesis generating. COVID is associated with the development of acute respiratory distress syndrome ARDS , intensive care unit admission, multi-organ failure, and death, especially in the elderly [ 1 , 2 ].

Elevated D-dimer and dysregulated coagulation have been reported in a significant proportion of hospitalized COVID patients in multiple studies [ 3 , 4 ] and found to be associated with a more severe course of the disease [ 5 , 6 ]. As the pandemic has progressed, multiple case-reports, reviews, and observational studies have reported an increased incidence of venous thromboembolic events VTE in hospitalized COVID patients [ 7 — 12 ].

It has been proposed that the increased risk of VTE is caused by a diffuse pulmonary intravascular coagulopathy resulting from pulmonary macrophage activation syndrome. In addition, a degree of cytokine storm-induced disseminated intravascular coagulation may add to the diffuse pulmonary intravascular coagulopathy beyond that of the macrophage activation [ 13 , 14 ]. Moreover, disease severity is associated with prolonged periods of inactivity which in turn increases the risk of VTE.