Incidence, risk factors, and thrombotic load of pulmonary embolism in patients hospitalized for COVID-19 infection.
COVID-19
Computed tomography
Inflammation
Pulmonary embolism
Thrombosis
Journal
The Journal of infection
ISSN: 1532-2742
Titre abrégé: J Infect
Pays: England
ID NLM: 7908424
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
11
09
2020
revised:
31
12
2020
accepted:
08
01
2021
pubmed:
14
1
2021
medline:
26
2
2021
entrez:
13
1
2021
Statut:
ppublish
Résumé
To determine the incidence, characteristics, and risk factors of pulmonary embolism (PE) among patients hospitalized for COVID-19. We performed a prospective observational study of a randomly selected cohort of consecutive patients hospitalized for COVID-19 infection between March 8, 2020 through April 25, 2020. All eligible patients underwent a computed tomography pulmonary angiography independently of their PE clinical suspicion and were pre-screened for a baseline elevated D-dimer level. 119 patients were randomly selected from the 372 admitted to one tertiary hospital in Valencia (Spain) for COVID-19 infection during the period of study. Seventy-three patients fulfilled both the inclusion criteria and none of the exclusion criteria and were finally included in the study. Despite a high level of pharmacological thromboprophylaxis (89%), the incidence of PE was 35.6% (95% confidence interval [CI], 29.6 to 41.6%), mostly with a peripheral location and low thrombotic load (Qanadli score 18.5%). Multivariate analysis showed that heart rate (Hazard Ratio [HR], 1.04), room-air oxygen saturation (spO2) (HR, 0.87), D-dimer (HR, 1.02), and C-reactive protein (CRP) levels (HR, 1.01) at the time of admission were independent predictors of incident PE during hospitalization. A risk score was constructed with these four variables showing a high predictive value of incident PE (AUC-ROC: 0.86; 95% CI: 0.80 to 0.93). Our findings confirmed a high incidence of PE in hospitalized COVID-19 patients. Heart rate, spO2, D-dimer, and CRP levels at admission were associated with higher rates of PE during hospitalization.
Identifiants
pubmed: 33440207
pii: S0163-4453(21)00007-4
doi: 10.1016/j.jinf.2021.01.003
pmc: PMC7834386
pii:
doi:
Substances chimiques
Anticoagulants
0
Fibrin Fibrinogen Degradation Products
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
261-269Informations de copyright
Copyright © 2021. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare no conflict of interest related to this study.
Références
Br J Haematol. 2020 Jun;189(6):1044-1049
pubmed: 32330308
N Engl J Med. 2020 Feb 20;382(8):727-733
pubmed: 31978945
Thromb Res. 2020 Sep;193:86-89
pubmed: 32531548
Nature. 2020 May;581(7809):465-469
pubmed: 32235945
J Thromb Haemost. 2020 Jul;18(7):1559-1561
pubmed: 32302453
Lancet Respir Med. 2020 Jul;8(7):681-686
pubmed: 32473124
Crit Care Resusc. 2020 Apr 15;22(2):95-97
pubmed: 32294809
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620936772
pubmed: 32726134
J Thromb Haemost. 2011 Oct;9(10):2115-7
pubmed: 21848693
Radiology. 2020 Apr;295(1):202-207
pubmed: 32017661
Transplantation. 2020 Nov;104(11):e329-e331
pubmed: 33122591
Thromb Res. 2020 Aug;192:23-26
pubmed: 32405101
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
Eur Respir J. 2011 Apr;37(4):762-6
pubmed: 20650994
Thromb Haemost. 2020 May;120(5):876-878
pubmed: 32246450
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
JAMA. 2014 Mar 19;311(11):1117-24
pubmed: 24643601
Crit Care Med. 2020 Sep;48(9):1358-1364
pubmed: 32467443
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
J Thromb Haemost. 2020 Jun;18(6):1421-1424
pubmed: 32271988
J Thromb Haemost. 2020 Jul;18(7):1743-1746
pubmed: 32320517
AJR Am J Roentgenol. 2001 Jun;176(6):1415-20
pubmed: 11373204
Lancet. 2007 Oct 20;370(9596):1453-7
pubmed: 18064739
J Microbiol Biotechnol. 2020 Mar 28;30(3):313-324
pubmed: 32238757
J Thromb Haemost. 2020 Apr;18(4):844-847
pubmed: 32073213
J Pathol. 2003 Jul;200(3):282-9
pubmed: 12845623
Thromb Res. 2020 Jun;190:102
pubmed: 32335420
J Thromb Haemost. 2018 Feb;16(2):231-241
pubmed: 29193703
Thromb Res. 2020 Nov;195:95-99
pubmed: 32682004
Intensive Care Med. 2020 Jun;46(6):1089-1098
pubmed: 32367170
Thromb Res. 2020 Jul;191:76-77
pubmed: 32402996
Res Pract Thromb Haemost. 2020 Jun 30;4(5):842-847
pubmed: 32685893
J Thromb Haemost. 2020 Aug;18(8):1995-2002
pubmed: 32369666
Eur Heart J. 2019 Nov 1;40(42):3453-3455
pubmed: 31697840
Eur Respir J. 2020 Jul 30;56(1):
pubmed: 32398297
Intensive Care Med. 2020 Nov;46(11):2089-2091
pubmed: 32929580
Scand J Clin Lab Invest. 2015 May;75(3):230-8
pubmed: 25608596
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Thromb Res. 2010 May;125(5):398-401
pubmed: 19683797
Eur Respir J. 2020 Jul 30;56(1):
pubmed: 32554532
Thromb Res. 2020 Jul;191:145-147
pubmed: 32291094
Radiology. 2020 Dec;297(3):E335-E338
pubmed: 32407256
J Am Coll Cardiol. 2020 Jun 16;75(23):2950-2973
pubmed: 32311448
Transl Res. 2020 Jun;220:1-13
pubmed: 32299776
Lancet Respir Med. 2020 Dec;8(12):1233-1244
pubmed: 33075298
Eur Respir J. 2020 Jul 30;56(1):
pubmed: 32554538
AJR Am J Roentgenol. 2009 Dec;193(6):1488-93
pubmed: 19933638
ERJ Open Res. 2020 Jul 13;6(2):
pubmed: 32685436
Lancet. 2020 Mar 28;395(10229):1033-1034
pubmed: 32192578
AJR Am J Roentgenol. 2020 Jul;215(1):87-93
pubmed: 32174129
Eur Respir J. 1999 Jun;13(6):1365-70
pubmed: 10445613
Chest. 2021 Mar;159(3):1182-1196
pubmed: 33217420
Circulation. 2020 Jul 14;142(2):184-186
pubmed: 32330083
Intensive Care Med. 2020 Aug;46(8):1603-1606
pubmed: 32415314