The prevalence of pulmonary embolism in patients with COVID-19 and respiratory decline: A three-setting comparison.
Aged
Aged, 80 and over
COVID-19
/ diagnostic imaging
Computed Tomography Angiography
Emergency Service, Hospital
Female
Humans
Intensive Care Units
Male
Middle Aged
Netherlands
/ epidemiology
Prevalence
Prognosis
Pulmonary Embolism
/ diagnostic imaging
Respiratory Insufficiency
/ diagnostic imaging
Risk Assessment
Risk Factors
Severity of Illness Index
COVID-19 (coronavirus disease 2019)
Computed tomography angiography
Pulmonary embolism
Thromboprophylaxis
Journal
Thrombosis research
ISSN: 1879-2472
Titre abrégé: Thromb Res
Pays: United States
ID NLM: 0326377
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
08
07
2020
revised:
30
09
2020
accepted:
09
10
2020
pubmed:
23
10
2020
medline:
15
12
2020
entrez:
22
10
2020
Statut:
ppublish
Résumé
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. 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. 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. 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)). 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.
Sections du résumé
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.
Identifiants
pubmed: 33091701
pii: S0049-3848(20)30556-9
doi: 10.1016/j.thromres.2020.10.012
pmc: PMC7557291
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
486-490Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Références
Thromb Res. 2020 Aug;192:23-26
pubmed: 32405101
N Engl J Med. 2020 Jul 9;383(2):120-128
pubmed: 32437596
J Thromb Haemost. 2020 Jul;18(7):1743-1746
pubmed: 32320517
Thromb Res. 2020 Jul;191:148-150
pubmed: 32381264
Ann Emerg Med. 2004 Nov;44(5):503-10
pubmed: 15520710
Ann Intern Med. 2020 Aug 18;173(4):268-277
pubmed: 32374815
Radiology. 2020 Aug;296(2):E97-E104
pubmed: 32339082
Thromb Res. 2020 Jul;191:9-14
pubmed: 32353746
BMJ Open. 2019 Oct 10;9(10):e031639
pubmed: 31601598
Thromb Res. 2020 Jul;191:145-147
pubmed: 32291094
Thromb Haemost. 2020 May;120(5):876-878
pubmed: 32246450
TH Open. 2020 Jun 08;4(2):e113-e115
pubmed: 32529170
Thromb Res. 2020 Sep;193:1-4
pubmed: 32485437
Thromb Res. 2020 Sep;193:86-89
pubmed: 32531548
Radiology. 2020 Sep;296(3):E186-E188
pubmed: 32324103
JAMA. 2020 Jun 23;323(24):2518-2520
pubmed: 32437497
J Thromb Haemost. 2020 Aug;18(8):1995-2002
pubmed: 32369666
Eur Respir J. 2020 Jul 30;56(1):
pubmed: 32398297
Thromb Haemost. 2020 Aug;120(8):1230-1232
pubmed: 32349132
Intensive Care Med. 1996 Jul;22(7):707-10
pubmed: 8844239
BMJ Open. 2020 Sep 29;10(9):e040175
pubmed: 32994259