The incidence, risk factors and clinical outcome of pulmonary embolism in hospitalized patients with COVID-19
Pulmonary embolism in hospitalized patients with COVID-19
Keywords:
Pulmonary Embolism, COVID-19, CT AngiographyAbstract
Objectives: Coronavirus-19 disease can cause a broad spectrum of diseases. One of the significant mortal complications of the disease is a hypercoagulable state, including life-threatening pulmonary embolism. COVID-19 infections may predispose venous thromboembolism due to excessive inflammation, hypoxia, immobilization, and diffuse intravascular coagulation. This study aimed to evaluate the incidence and risk factors for pulmonary embolism in hospitalized patients with COVID-19 in Turkey and to determine the impact of pulmonary embolism on clinical outcomes.
Results: 69 patients who were hospitalized for COVID-19 pneumonia between 15 March and 30 April 2020 and underwent CT angiography on clinical suspicion were included in the study. All patients received at least standard doses of thromboprophylaxis. The incidence of PE was %24.4(n=17). In patients with pulmonary embolism, a higher frequency of males (88% vs. 61%,p=0.013 ), higher rates of smoking(75% vs. 37%,p=0.008 ), and chronic renal failure (19% vs. 4%,p=0.04 ) were noted. Pulmonary embolism was positively correlated with heart rate >100 bpm (r=0.479,p<0.001), more than two-fold increase in D-dimer (r=0.421,p<0.001), and active smoking (r=0.323,p=0.008).In three patients with pulmonary embolism, intensive care, non-invasive mechanical ventilation, and intubation were required, and mortality occurred only in 1 (6.0%) patient.
Conclusion: In our study, the frequency of pulmonary embolism in the patient population infected with COVID-19 was 24.4%, despite effective DVT prophylaxis. It should be kept in mind that pulmonary embolism is one of the most common complications in patients hospitalized for COVID-19 infection.
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