tetano
Editor, Senior Moderator
Thromb Res
. 2020 Oct 15;196:486-490.
doi: 10.1016/j.thromres.2020.10.012. Online ahead of print.
The prevalence of pulmonary embolism in patients with COVID-19 and respiratory decline: A three-setting comparison
Ren?e A G Br?ggemann[SUP] 1 [/SUP], Bart Spaetgens[SUP] 2 [/SUP], Hester A Gietema[SUP] 3 [/SUP], Steffie H A Brouns[SUP] 2 [/SUP], Patricia M Stassen[SUP] 2 [/SUP], Fabienne J Magdelijns[SUP] 2 [/SUP], Roger J Rennenberg[SUP] 2 [/SUP], Ronald M A Henry[SUP] 2 [/SUP], Mark M G Mulder[SUP] 4 [/SUP], Bas C T van Bussel[SUP] 5 [/SUP], Ronny M Schnabel[SUP] 4 [/SUP], Iwan C C van der Horst[SUP] 6 [/SUP], Joachim E Wildberger[SUP] 7 [/SUP], Coen D A Stehouwer[SUP] 8 [/SUP], Hugo Ten Cate[SUP] 9 [/SUP]
Affiliations
Abstract
Background: The risk of pulmonary embolism (PE) in patients with Coronavirus Disease 2019 (COVID-19) is recognized. The prevalence of PE in patients with respiratory deterioration at the Emergency Department (ED), the regular ward, and the Intensive Care Unit (ICU) are not well-established.
Objectives: We aimed to investigate how often PE was present in individuals with COVID-19 and respiratory deterioration in different settings, and whether or not disease severity as measured by CT-severity score (CTSS) was related to the occurrence of PE.
Patients/methods: Between April 6th and May 3rd, we enrolled 60 consecutive adult patients with confirmed COVID-19 from the ED, regular ward and ICU who met the pre-specified criteria for respiratory deterioration.
Results: A total of 24 (24/60: 40% (95% CI: 28-54%)) patients were diagnosed with PE, of whom 6 were in the ED (6/23: 26% (95% CI: 10-46%)), 8 in the regular ward (8/24: 33% (95% CI: 16-55%)), and 10 in the ICU (10/13: 77% (95% CI: 46-95%)). CTSS (per unit) was not associated with the occurrence of PE (age and sex-adjusted OR 1.06 (95%CI 0.98-1.15)).
Conclusion: The number of PE diagnosis among patients with COVID-19 and respiratory deterioration was high; 26% in the ED, 33% in the regular ward and 77% in the ICU respectively. In our cohort CTSS was not associated with the occurrence of PE. Based on the high number of patients diagnosed with PE among those scanned we recommend a low threshold for performing computed tomography angiography in patients with COVID-19 and respiratory deterioration.
Keywords: COVID-19 (coronavirus disease 2019); Computed tomography angiography; Pulmonary embolism; Thromboprophylaxis.
. 2020 Oct 15;196:486-490.
doi: 10.1016/j.thromres.2020.10.012. Online ahead of print.
The prevalence of pulmonary embolism in patients with COVID-19 and respiratory decline: A three-setting comparison
Ren?e A G Br?ggemann[SUP] 1 [/SUP], Bart Spaetgens[SUP] 2 [/SUP], Hester A Gietema[SUP] 3 [/SUP], Steffie H A Brouns[SUP] 2 [/SUP], Patricia M Stassen[SUP] 2 [/SUP], Fabienne J Magdelijns[SUP] 2 [/SUP], Roger J Rennenberg[SUP] 2 [/SUP], Ronald M A Henry[SUP] 2 [/SUP], Mark M G Mulder[SUP] 4 [/SUP], Bas C T van Bussel[SUP] 5 [/SUP], Ronny M Schnabel[SUP] 4 [/SUP], Iwan C C van der Horst[SUP] 6 [/SUP], Joachim E Wildberger[SUP] 7 [/SUP], Coen D A Stehouwer[SUP] 8 [/SUP], Hugo Ten Cate[SUP] 9 [/SUP]
Affiliations
- PMID: 33091701
- PMCID: PMC7557291
- DOI: 10.1016/j.thromres.2020.10.012
Abstract
Background: The risk of pulmonary embolism (PE) in patients with Coronavirus Disease 2019 (COVID-19) is recognized. The prevalence of PE in patients with respiratory deterioration at the Emergency Department (ED), the regular ward, and the Intensive Care Unit (ICU) are not well-established.
Objectives: We aimed to investigate how often PE was present in individuals with COVID-19 and respiratory deterioration in different settings, and whether or not disease severity as measured by CT-severity score (CTSS) was related to the occurrence of PE.
Patients/methods: Between April 6th and May 3rd, we enrolled 60 consecutive adult patients with confirmed COVID-19 from the ED, regular ward and ICU who met the pre-specified criteria for respiratory deterioration.
Results: A total of 24 (24/60: 40% (95% CI: 28-54%)) patients were diagnosed with PE, of whom 6 were in the ED (6/23: 26% (95% CI: 10-46%)), 8 in the regular ward (8/24: 33% (95% CI: 16-55%)), and 10 in the ICU (10/13: 77% (95% CI: 46-95%)). CTSS (per unit) was not associated with the occurrence of PE (age and sex-adjusted OR 1.06 (95%CI 0.98-1.15)).
Conclusion: The number of PE diagnosis among patients with COVID-19 and respiratory deterioration was high; 26% in the ED, 33% in the regular ward and 77% in the ICU respectively. In our cohort CTSS was not associated with the occurrence of PE. Based on the high number of patients diagnosed with PE among those scanned we recommend a low threshold for performing computed tomography angiography in patients with COVID-19 and respiratory deterioration.
Keywords: COVID-19 (coronavirus disease 2019); Computed tomography angiography; Pulmonary embolism; Thromboprophylaxis.