Pulmonary ischaemia without pulmonary arterial thrombus in COVID-19 patients receiving extracorporeal membrane oxygenation: a cohort study.
Adult
Aged
Betacoronavirus
COVID-19
Cohort Studies
Coronavirus Infections
/ complications
Extracorporeal Membrane Oxygenation
/ methods
Female
Humans
Lung
/ diagnostic imaging
Male
Middle Aged
Pandemics
Pneumonia, Viral
/ complications
Pulmonary Embolism
/ complications
SARS-CoV-2
Tomography, X-Ray Computed
Journal
Clinical radiology
ISSN: 1365-229X
Titre abrégé: Clin Radiol
Pays: England
ID NLM: 1306016
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
13
07
2020
accepted:
13
07
2020
pubmed:
12
8
2020
medline:
23
9
2020
entrez:
12
8
2020
Statut:
ppublish
Résumé
To evaluate the incidence of pulmonary ischaemia in COVID-19 patients on extracorporeal membrane oxygenation (ECMO), and its correlation with pulmonary artery thrombosis. Computed tomography (CT) thorax of all patients receiving ECMO with proven COVID-19 pneumonitis between March and May 2020 were analysed for the presence and extension of pulmonary thromboembolic disease. Fifty-one patients were reviewed. The mean (range) age of 45 (26-66) years; 38/51 (74.5%) were men. All patients had severe COVID-19 pneumonitis, and 18/51 (35.3%) had macroscopic thrombosis (15 with associated ischaemia); however, 13/51 (25.5%) patients had ischaemia without associated thrombus. The majority of patients with COVID-19 who received ECMO had areas of ischaemia within consolidated lungs, almost half of these without subtending pulmonary artery thrombosis. Although the prognostic significance of these findings is unclear, they are highly suggestive of lung ischaemia due to isolated microvascular immune thrombosis.
Identifiants
pubmed: 32778329
pii: S0009-9260(20)30275-0
doi: 10.1016/j.crad.2020.07.006
pmc: PMC7368894
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
795.e1-795.e5Informations de copyright
Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.
Références
N Engl J Med. 2020 Jul 9;383(2):120-128
pubmed: 32437596
Eur Heart J. 2020 May 14;41(19):1858
pubmed: 32227120
Lancet Respir Med. 2020 May;8(5):440-442
pubmed: 32247325
J Clin Virol. 2020 Jun;127:104362
pubmed: 32305883
Clin Chem Lab Med. 2020 Jun 25;58(7):1116-1120
pubmed: 32172226
Lancet. 2003 May 24;361(9371):1773-8
pubmed: 12781536
ASAIO J. 2020 May;66(5):472-474
pubmed: 32243267
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
J Thromb Haemost. 2020 Jun;18(6):1511-1513
pubmed: 32293083
Thromb Res. 2020 Jul;191:145-147
pubmed: 32291094