tetano
Editor, Senior Moderator
Radiol Med
. 2021 Jan 8.
doi: 10.1007/s11547-020-01328-2. Online ahead of print.
Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area
Davide Ippolito[SUP] 1 2 [/SUP], Teresa Giandola[SUP] 1 2 [/SUP], Cesare Maino[SUP] 3 4 [/SUP], Anna Pecorelli[SUP] 1 2 [/SUP], Carlo Capodaglio[SUP] 1 2 [/SUP], Maria Ragusi[SUP] 1 2 [/SUP], Marco Porta[SUP] 1 2 [/SUP], Davide Gandola[SUP] 1 2 [/SUP], Alessandro Masetto[SUP] 5 [/SUP], Silvia Drago[SUP] 2 [/SUP], Pietro Allegranza[SUP] 6 [/SUP], Rocco Corso[SUP] 2 [/SUP], Cammillo Talei Franzesi[SUP] 1 2 [/SUP], Sandro Sironi[SUP] 1 7 [/SUP]
Affiliations
Abstract
Purpose: To analyze pulmonary embolism (PE) on chest computed tomography pulmonary angiography (CTPA) in hospitalized patients affected by SARS-CoV-2, according to the severity of lung disease based both on temporal CT features changes and on CT-severity lung involvement (CT-severity score), along with the support of clinical and laboratory findings.
Methods: We retrospectively enrolled a total of 170 patients with confirmed SARS-CoV-2 infection who underwent CTPA examination for PE suspicion. Pulmonary arteries diameters, right ventricle/left ventricle (RV/LV) ratio, presence, absence, and distribution of PE, pulmonary artery obstructive index (PAO index), and lobe involvement were recorded. All CT scans were reviewed to assess temporal CT changes and the COVID CT-severity score.
Results: A total of 76 out of 170 patients (44.7%) developed PE without having any major risk factors for venous thromboembolism. The most severe pulmonary arteries involvement, expressed in terms of PAO Index, occurred in those patients with markedly elevated D-dimer and C-reactive protein (CRP) values and those patients with an advanced temporal stage of lung disease. The majority PE-positive patients were hospitalized in non-intensive wards. PE-positive patients showed a slightly higher hospitalization time in comparison with PE-negative ones. In the three months of study, overall 85.9% of patients were discharged while 14.1% died, of whom 13 PE-positive (54.2%).
Conclusions: Patients hospitalized for SARS-CoV-2 infection present a higher cumulative incidence of PE compared to the general population of hospitalized patients, regardless of the severity of lung inflammation or the temporal stage of the disease.
Keywords: Acute pulmonary embolism; Coronavirus; Infections; Tomography; X-ray computed.
. 2021 Jan 8.
doi: 10.1007/s11547-020-01328-2. Online ahead of print.
Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area
Davide Ippolito[SUP] 1 2 [/SUP], Teresa Giandola[SUP] 1 2 [/SUP], Cesare Maino[SUP] 3 4 [/SUP], Anna Pecorelli[SUP] 1 2 [/SUP], Carlo Capodaglio[SUP] 1 2 [/SUP], Maria Ragusi[SUP] 1 2 [/SUP], Marco Porta[SUP] 1 2 [/SUP], Davide Gandola[SUP] 1 2 [/SUP], Alessandro Masetto[SUP] 5 [/SUP], Silvia Drago[SUP] 2 [/SUP], Pietro Allegranza[SUP] 6 [/SUP], Rocco Corso[SUP] 2 [/SUP], Cammillo Talei Franzesi[SUP] 1 2 [/SUP], Sandro Sironi[SUP] 1 7 [/SUP]
Affiliations
- PMID: 33417194
- DOI: 10.1007/s11547-020-01328-2
Abstract
Purpose: To analyze pulmonary embolism (PE) on chest computed tomography pulmonary angiography (CTPA) in hospitalized patients affected by SARS-CoV-2, according to the severity of lung disease based both on temporal CT features changes and on CT-severity lung involvement (CT-severity score), along with the support of clinical and laboratory findings.
Methods: We retrospectively enrolled a total of 170 patients with confirmed SARS-CoV-2 infection who underwent CTPA examination for PE suspicion. Pulmonary arteries diameters, right ventricle/left ventricle (RV/LV) ratio, presence, absence, and distribution of PE, pulmonary artery obstructive index (PAO index), and lobe involvement were recorded. All CT scans were reviewed to assess temporal CT changes and the COVID CT-severity score.
Results: A total of 76 out of 170 patients (44.7%) developed PE without having any major risk factors for venous thromboembolism. The most severe pulmonary arteries involvement, expressed in terms of PAO Index, occurred in those patients with markedly elevated D-dimer and C-reactive protein (CRP) values and those patients with an advanced temporal stage of lung disease. The majority PE-positive patients were hospitalized in non-intensive wards. PE-positive patients showed a slightly higher hospitalization time in comparison with PE-negative ones. In the three months of study, overall 85.9% of patients were discharged while 14.1% died, of whom 13 PE-positive (54.2%).
Conclusions: Patients hospitalized for SARS-CoV-2 infection present a higher cumulative incidence of PE compared to the general population of hospitalized patients, regardless of the severity of lung inflammation or the temporal stage of the disease.
Keywords: Acute pulmonary embolism; Coronavirus; Infections; Tomography; X-ray computed.