Pulmonary embolism in COVID-19 pneumonia patients admitted to temporary hospital - The follow-up study.
COVID-19
Prognosis
Pulmonary embolism
Journal
Advances in medical sciences
ISSN: 1898-4002
Titre abrégé: Adv Med Sci
Pays: Netherlands
ID NLM: 101276222
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
17
04
2023
revised:
04
07
2023
accepted:
18
08
2023
medline:
24
11
2023
pubmed:
27
8
2023
entrez:
26
8
2023
Statut:
ppublish
Résumé
Coronavirus disease 2019 (COVID-19) is linked with major coagulation disorders, especially higher risk of developing pulmonary embolism (PE). Our study summarizes COVID-19 patients' management with concomitant PE during the first weeks of pandemic and underlines the importance of D-dimer concentration assessment at admission in terms of prognosis. Study group consisted of 107 outpatients (mean age 68.91 ± 12.83 years) admitted to the Temporary COVID-19 Hospital in Bialystok, Poland with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and suspicion of PE based on elevated D-dimer concentration (>500 μg/l) and/or low saturation rate (<90%). The clinical follow-up lasted 6 months. Death or re-hospitalization were used as composite clinical endpoint (CEP). Cumulative incidence of PE was 62.3% (73/107 patients). Most of the patients were in the intermediate PE risk group according to the pulmonary embolism severity index (PESI) score. The mean total computed tomography (CT) lung involvement of COVID-19 findings was 48.42 ± 27.71%. Neither D-dimers nor NT-proBNP concentrations correlated significantly with the percentage of lung abnormalities in CT. Patients with baseline D-dimer concentration higher than 1429 μg/l had worse prognosis in 6-months observation, log-rank test, p = 0.009. Ongoing SARS-CoV-2 infection along with massive involvement of lung tissue and concomitant thrombi in pulmonary arteries are challenging for physicians. It seems that simple D-dimer concentration assessment at admission may be a helpful tool not only to predict PE but also to estimate the long-term prognosis.
Identifiants
pubmed: 37633116
pii: S1896-1126(23)00026-3
doi: 10.1016/j.advms.2023.08.002
pii:
doi:
Substances chimiques
Fibrin Fibrinogen Degradation Products
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
270-275Informations de copyright
Copyright © 2023 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare no conflict of interests.