Pulmonary artery thrombi are co-located with opacifications in SARS-CoV2 induced ARDS.
Betacoronavirus
/ isolation & purification
Blood Coagulation
COVID-19
Computed Tomography Angiography
/ methods
Coronavirus Infections
/ blood
Correlation of Data
Female
Humans
Lung
/ diagnostic imaging
Male
Middle Aged
Pandemics
Pneumonia, Viral
/ blood
Pulmonary Artery
/ diagnostic imaging
Pulmonary Embolism
/ diagnosis
Radiography, Thoracic
/ methods
Respiratory Distress Syndrome
/ diagnosis
Retrospective Studies
SARS-CoV-2
Thrombosis
/ diagnostic imaging
COVID19
CT-Scan
CTPA
Pulmonary artery thrombosis
Pulmonary embolism
SARS-CoV2
Journal
Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
12
06
2020
revised:
25
08
2020
accepted:
27
08
2020
pubmed:
19
9
2020
medline:
21
10
2020
entrez:
18
9
2020
Statut:
ppublish
Résumé
Patients hospitalized for infection with SARS-CoV-2 typically present with pneumonia. The respiratory failure is frequently complicated by pulmonary embolism in segmental pulmonary arteries. The distribution of pulmonary embolism in regard to lung parenchymal opacifications has not been investigated yet. All patients with COVID-19 treated at a medical intensive care unit between March 8th and April 15th, 2020 undergoing computed tomography pulmonary angiography (CTPA) were included. All CTPA were assessed by two radiologists independently in respect to parenchymal changes and pulmonary embolism on a lung segment basis. Out of 22 patients with severe COVID-19 treated within the observed time period, 16 (age 60.4 ± 10.2 years, 6 female SAPS2 score 49.2 ± 13.9) underwent CT. A total of 288 lung segment were analyzed. Thrombi were detectable in 9/16 (56.3%) patients, with 4.4 ± 2.9 segments occluded per patient and 40/288 (13.9%) segments affected in the whole cohort. Patients with thrombi had significantly worse segmental opacifications in CT (p < 0.05) and all thrombi were located in opacitated segments. There was no correlation between d-dimer level and number of occluded segmental arteries. Thrombi in segmental pulmonary arteries are common in COVID-19 and are located in opacitated lung segments. This might suggest local clot formation.
Identifiants
pubmed: 32947171
pii: S0954-6111(20)30275-4
doi: 10.1016/j.rmed.2020.106135
pmc: PMC7483034
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
106135Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
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