tetano
Editor, Senior Moderator
Thromb Res
. 2020 Nov 7;197:94-99.
doi: 10.1016/j.thromres.2020.11.001. Online ahead of print.
Prevalence and characteristics of pulmonary embolism in 1042 COVID-19 patients with respiratory symptoms: A nested case-control study
Benjamin Planquette[SUP] 1 [/SUP], Alice Le Berre[SUP] 2 [/SUP], Lina Khider[SUP] 3 [/SUP], Alexandra Yannoutsos[SUP] 4 [/SUP], Nicolas Gendron[SUP] 5 [/SUP], Marie de Torcy[SUP] 6 [/SUP], Nassim Mohamedi[SUP] 7 [/SUP], St?phane Jouveshomme[SUP] 6 [/SUP], David M Smadja[SUP] 8 [/SUP], Isabelle Lazareth[SUP] 9 [/SUP], Guillaume Goudot[SUP] 3 [/SUP], Laure Fournier[SUP] 10 [/SUP], C?dric Bruel[SUP] 11 [/SUP], Jean Luc Diehl[SUP] 12 [/SUP], Jean-Jacques Mourad[SUP] 13 [/SUP], Guy Meyer[SUP] 14 [/SUP], Pascal Priollet[SUP] 9 [/SUP], Emmanuel Messas[SUP] 15 [/SUP], Olivier Sanchez[SUP] 16 [/SUP], H?l?ne Beaussier[SUP] 17 [/SUP], Tristan Mirault[SUP] 18 [/SUP], Marc Zins[SUP] 2 [/SUP], Gilles Chatelier[SUP] 19 [/SUP], Joseph Emmerich[SUP] 20 [/SUP]
Affiliations
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) has been associated with cardiovascular complications and coagulation disorders. Previous studies reported pulmonary embolism (PE) in severe COVID-19 patients. Aim of the study was to estimate the prevalence of symptomatic PE in COVID-19 patients and to identify the clinical, radiological or biological characteristics associated with PE.
Patients/methods: We conducted a retrospective nested case-control study in 2 French hospitals. Controls were matched in a 1:2 ratio on the basis of age, sex and center. PE patients with COVID-19 were compared to patients in whom PE was ruled out (CTPA controls) and in whom PE has not been investigated (CT controls).
Results: PE was suspected in 269 patients among 1042 COVID-19 patients, and confirmed in 59 patients (5.6%). Half of PE was diagnosed at COVID-19 diagnosis. PE patients did not differ from CT and CTPA controls for thrombosis risk factors. PE patients more often required invasive ventilation compared to CTPA controls (odds ratio (OR) 2.79; 95% confidence interval (CI) 1.33-5.84) and to CT controls (OR 8.07; 95% CI 2.70-23.82). PE patients exhibited more extensive parenchymal lesions (>50%) than CT controls (OR 3.90; 95% CI 1.54-9.94). D-dimer levels were 5.1 (95% CI 1.90-13.76) times higher in PE patients than CTPA controls.
Conclusions: Our results suggest a PE prevalence in COVID-19 patients close to 5% in the whole population and to 20% of the clinically suspected population. PE seems to be associated with more extensive lung damage and to require more frequently invasive ventilation.
Keywords: COVID-19; CTPA; D-dimer; Pulmonary embolism.
. 2020 Nov 7;197:94-99.
doi: 10.1016/j.thromres.2020.11.001. Online ahead of print.
Prevalence and characteristics of pulmonary embolism in 1042 COVID-19 patients with respiratory symptoms: A nested case-control study
Benjamin Planquette[SUP] 1 [/SUP], Alice Le Berre[SUP] 2 [/SUP], Lina Khider[SUP] 3 [/SUP], Alexandra Yannoutsos[SUP] 4 [/SUP], Nicolas Gendron[SUP] 5 [/SUP], Marie de Torcy[SUP] 6 [/SUP], Nassim Mohamedi[SUP] 7 [/SUP], St?phane Jouveshomme[SUP] 6 [/SUP], David M Smadja[SUP] 8 [/SUP], Isabelle Lazareth[SUP] 9 [/SUP], Guillaume Goudot[SUP] 3 [/SUP], Laure Fournier[SUP] 10 [/SUP], C?dric Bruel[SUP] 11 [/SUP], Jean Luc Diehl[SUP] 12 [/SUP], Jean-Jacques Mourad[SUP] 13 [/SUP], Guy Meyer[SUP] 14 [/SUP], Pascal Priollet[SUP] 9 [/SUP], Emmanuel Messas[SUP] 15 [/SUP], Olivier Sanchez[SUP] 16 [/SUP], H?l?ne Beaussier[SUP] 17 [/SUP], Tristan Mirault[SUP] 18 [/SUP], Marc Zins[SUP] 2 [/SUP], Gilles Chatelier[SUP] 19 [/SUP], Joseph Emmerich[SUP] 20 [/SUP]
Affiliations
- PMID: 33190025
- PMCID: PMC7648521
- DOI: 10.1016/j.thromres.2020.11.001
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) has been associated with cardiovascular complications and coagulation disorders. Previous studies reported pulmonary embolism (PE) in severe COVID-19 patients. Aim of the study was to estimate the prevalence of symptomatic PE in COVID-19 patients and to identify the clinical, radiological or biological characteristics associated with PE.
Patients/methods: We conducted a retrospective nested case-control study in 2 French hospitals. Controls were matched in a 1:2 ratio on the basis of age, sex and center. PE patients with COVID-19 were compared to patients in whom PE was ruled out (CTPA controls) and in whom PE has not been investigated (CT controls).
Results: PE was suspected in 269 patients among 1042 COVID-19 patients, and confirmed in 59 patients (5.6%). Half of PE was diagnosed at COVID-19 diagnosis. PE patients did not differ from CT and CTPA controls for thrombosis risk factors. PE patients more often required invasive ventilation compared to CTPA controls (odds ratio (OR) 2.79; 95% confidence interval (CI) 1.33-5.84) and to CT controls (OR 8.07; 95% CI 2.70-23.82). PE patients exhibited more extensive parenchymal lesions (>50%) than CT controls (OR 3.90; 95% CI 1.54-9.94). D-dimer levels were 5.1 (95% CI 1.90-13.76) times higher in PE patients than CTPA controls.
Conclusions: Our results suggest a PE prevalence in COVID-19 patients close to 5% in the whole population and to 20% of the clinically suspected population. PE seems to be associated with more extensive lung damage and to require more frequently invasive ventilation.
Keywords: COVID-19; CTPA; D-dimer; Pulmonary embolism.