The prevalence of pulmonary embolism in patients with COVID-19 and respiratory decline: A three-setting comparison
Autor
Brüggemann, Renée R.A.G.
Spaetgens, Bart
Gietema, Hester A.
Brouns, Steffie H.A.
Stassen, Patricia M.
Magdelijns, Fabienne J.
Rennenberg, Roger J.
Henry, Ronald M.A.
Mulder, Mark M.G.
Bussel, Bas C.T. van
Schnabel, Ronny M.
Horst, Iwan C.C. van der
Wildberger, Joachim E.
Stehouwer, Coen D.A.
Cate, Hugo ten
Institución
Resumen
Background The risk of pulmonary embolism (PE) in patients with Coronavirus
Disease 2019 (COVID-19) is recognized. The prevalence of PE in patients with
respiratory deterioration at the Emergency Department (ED), the regular ward, and
the Intensive Care Unit (ICU) are not well-established.
Objectives We aimed to investigate how often PE was present in individuals with
COVID-19 and respiratory deterioration in different settings, and whether or not
disease severity as measured by CT-severity score (CTSS) was related to the
occurrence of PE.
Patients/Methods Between April 6th and May 3rd, we enrolled 60 consecutive adult
patients with confirmed COVID-19 from the ED, regular ward and ICU who met the
pre-specified criteria for respiratory deterioration.
Results A total of 24 (24/60: 40% (95%CI: 28-54%)) patients were diagnosed with
PE, of whom 6 were in the ED (6/23: 26% (95% CI: 10-46%)), 8 in the regular ward
(8/24: 33% (95%CI: 16-55%)), and 10 in the ICU (10/13: 77% (95%CI: 46-95%)).
CTSS (per unit) was not associated with the occurrence of PE (age and sex-adjusted
OR 1.06 (95%CI 0.98-1.15)).
Conclusion The number of PE diagnosis among patients with COVID-19 and
respiratory deterioration was high; 26% in the ED, 33% in the regular ward and 77%
in the ICU respectively. In our cohort CTSS was not associated with the occurrence
of PE. Based on the high number of patients diagnosed with PE among those
scanned we recommend a low threshold for performing computed tomography
angiography in patients with COVID-19 and respiratory deterioration.