tetano
Editor, Senior Moderator
Respir Res
. 2022 Oct 31;23(1):296.
doi: 10.1186/s12931-022-02188-2.
Lung perfusion assessed by SPECT/CT after a minimum of three months anticoagulation therapy in patients with SARS-CoV-2-associated acute pulmonary embolism: a retrospective observational study
Thomas M Berghaus[SUP] 1 2 [/SUP], Stefanie Bader[SUP] 3 [/SUP], Christian Faul[SUP] 3 [/SUP], Sabine Haberl[SUP] 3 [/SUP], Florian Schwarz[SUP] 4 5 [/SUP], Alessandro Liebich[SUP] 6 [/SUP], Alexander Dierks[SUP] 6 [/SUP], Malte Kircher[SUP] 6 [/SUP], Constantin Lapa[SUP] 6 [/SUP], Christian H Pfob[SUP] 6 [/SUP]
Affiliations
Abstract
Background: Anticoagulant treatment is recommended for at least three months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related acute pulmonary embolism (PE), but the persistent pulmonary clot burden after that time is unknown.
Methods: Lung perfusion was assessed by ventilation-perfusion (V/Q) SPECT/CT in 20 consecutive patients with SARS-CoV-2-associated acute PE after a minimum of three months anticoagulation therapy in a retrospective observational study.
Results: Remaining perfusion defects after a median treatment period of six months were observed in only two patients. All patients (13 men, seven women, mean age 55.6 ± 14.5 years) were on non-vitamin K direct oral anticoagulants (DOACs). No recurrent venous thromboembolism or anticoagulant-related bleeding complications were observed. Among patients with partial clinical recovery, high-risk PE and persistent pulmonary infiltrates were significantly more frequent (p < 0.001, respectively).
Interpretation: Temporary DOAC treatment seems to be safe and efficacious for resolving pulmonary clot burden in SARS-CoV-2-associated acute PE. Partial clinical recovery is more likely caused by prolonged SARS-CoV-2-related parenchymal lung damage rather than by persistent pulmonary perfusion defects.
Keywords: Acute pulmonary embolism; Anticoagulation therapy; COVID-19; DOAC; Persistent pulmonary perfusion defects; SARS-CoV-2; SPECT/CT.
. 2022 Oct 31;23(1):296.
doi: 10.1186/s12931-022-02188-2.
Lung perfusion assessed by SPECT/CT after a minimum of three months anticoagulation therapy in patients with SARS-CoV-2-associated acute pulmonary embolism: a retrospective observational study
Thomas M Berghaus[SUP] 1 2 [/SUP], Stefanie Bader[SUP] 3 [/SUP], Christian Faul[SUP] 3 [/SUP], Sabine Haberl[SUP] 3 [/SUP], Florian Schwarz[SUP] 4 5 [/SUP], Alessandro Liebich[SUP] 6 [/SUP], Alexander Dierks[SUP] 6 [/SUP], Malte Kircher[SUP] 6 [/SUP], Constantin Lapa[SUP] 6 [/SUP], Christian H Pfob[SUP] 6 [/SUP]
Affiliations
- PMID: 36316693
- DOI: 10.1186/s12931-022-02188-2
Abstract
Background: Anticoagulant treatment is recommended for at least three months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related acute pulmonary embolism (PE), but the persistent pulmonary clot burden after that time is unknown.
Methods: Lung perfusion was assessed by ventilation-perfusion (V/Q) SPECT/CT in 20 consecutive patients with SARS-CoV-2-associated acute PE after a minimum of three months anticoagulation therapy in a retrospective observational study.
Results: Remaining perfusion defects after a median treatment period of six months were observed in only two patients. All patients (13 men, seven women, mean age 55.6 ± 14.5 years) were on non-vitamin K direct oral anticoagulants (DOACs). No recurrent venous thromboembolism or anticoagulant-related bleeding complications were observed. Among patients with partial clinical recovery, high-risk PE and persistent pulmonary infiltrates were significantly more frequent (p < 0.001, respectively).
Interpretation: Temporary DOAC treatment seems to be safe and efficacious for resolving pulmonary clot burden in SARS-CoV-2-associated acute PE. Partial clinical recovery is more likely caused by prolonged SARS-CoV-2-related parenchymal lung damage rather than by persistent pulmonary perfusion defects.
Keywords: Acute pulmonary embolism; Anticoagulation therapy; COVID-19; DOAC; Persistent pulmonary perfusion defects; SARS-CoV-2; SPECT/CT.