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Heart Lung . High incidence of pulmonary thromboembolism in hospitalized SARS-CoV-2 infected patients despite thrombo-prophylaxis

tetano

Editor, Senior Moderator
Heart Lung


. 2022 Feb 8;53:77-82.
doi: 10.1016/j.hrtlng.2022.02.003. Online ahead of print.
High incidence of pulmonary thromboembolism in hospitalized SARS-CoV-2 infected patients despite thrombo-prophylaxis


D El-Qutob[SUP] 1 [/SUP], L Alvarez-Arroyo[SUP] 2 [/SUP], I Barreda[SUP] 3 [/SUP], M Nieto[SUP] 4 [/SUP], M Pin[SUP] 5 [/SUP], José Luis Poveda-Andrés[SUP] 6 [/SUP], F J Carrera-Hueso[SUP] 7 [/SUP]



Affiliations
Free PMC article

Abstract

Background: SARS-CoV-2 infected patients present thrombotic complications caused by direct endothelial cells injury of the microvessels. Pulmonary thromboembolism (PE) has been reported by Computed Tomography pulmonary angiogram (CTPA) in patients with COVID-19 pneumonia with high D-dimer levels.
Objectives: We present the characteristics of SARS-CoV-2 infected patients diagnosed of PE by CTPA in our hospital. We also present the comparison of these findings with non-infected patients with PE data.
Methods: Retrospective observational cohort study that included patients over 18 years of age hospitalised consecutively between 26th February and 20th May 2020 in an European Hospital with SARS-CoV2 virus infection, and with suspected infection at beginning of admission but with negative PCR, who were studied with CTPA for suspicion of VTE, during their hospitalization.
Results: During the study period, 52 CTPA were performed in our hospital, sixteen in SARS-CoV-2 infected patients, with 4 cases (33%) of PE in the infected group, and 11 (44%) in the non-infected group. No significant differences in age (p = 0.43) and sex (p = 0.31) were found between the two groups, infected and non-infected patients. In the infected group, the patients who had PE had a much lower median age (47.8 years) than those without PE (73.3 years). No differences between infected and non-infected patients were detected in the diagnosis of PE with CTPA, 28.6% versus 27.8% (p = 1.00). Overall patient mortality was 1.9%; one patient died (6.3%) in the infected group, and none in the non-infected group (p = 0.31).
Conclusion: A considerable incidence of PE diagnosed by CTPA in SARS-CoV-2 infected patients has been observed, despite thrombo-prophylaxis.

Keywords: COVID-19; Coagulation; Coronavirus; SARS-CoV-2; Thromboembolism; Thrombosis.
 
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