Evaluation of pulmonary embolism in the pace of covid-19


Akkus C., YILMAZ H., ADIBELLİ Z., Demirci H., KARTAL M., DURAN C.

Acta Medica Mediterranea, cilt.37, sa.5, ss.2329-2335, 2021 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 37 Sayı: 5
  • Basım Tarihi: 2021
  • Doi Numarası: 10.19193/0393-6384_2021_5_361
  • Dergi Adı: Acta Medica Mediterranea
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Sayfa Sayıları: ss.2329-2335
  • Anahtar Kelimeler: Coagulopathy, COVID-19, D-dimer, Pulmonary embolism, SARS-CoV-2, Thromboembolism
  • Uşak Üniversitesi Adresli: Evet

Özet

Background: To investigate the prevalence and clinical and laboratory characteristics of the cases with pulmonary embolism (PE) in the pace of coronavirus disease-2019 (COVID-19). Materials and methods: COVID-19 patients' records were retrospectively scanned from the hospital's automation system and recorded on patients' files. Results: Of 1452 COVID-19 patients, 17 (1.2%) were diagnosed with PE. Compared cases with PE with controls, it was seen that mean age was higher (p=0.036), male gender was prominent (p=0.016), patients presented with dyspnea symptoms further (p<0.001), while O2 saturation measured at room air on admission was lower (p=0.002). In PE patients, glucose (p=0.007), D-dimer (p<0.001), C-reactive protein (p<0.001) and ferritin levels (p=0.002) were higher than controls. In Receiver-Operator Characteristics analysis, the cut-off value of D-dimer in predicting PE was found to be 4211 ng/mL (p<0.001). COVID-19 patients were diagnosed with PE median five (min:max=0:36) days after hospitalization. Additionally, PE patients were found to have longer hospitalization time (p<0.001), the requirement for caring in the intensive care unit (p<0.001), and intubation (p=0.001), and non-invasive mechanical ventilation (p<0.001) in more patients, compared to controls. Mortality rates were similar in both groups, with three and 106 deaths in PE and control groups, respectively. Lower-extremity Doppler ultrasonography was performed in 196 patients, and thrombi were detected in the femoral vein in four patients, also presenting with PE. Conclusions: Even if there is no embolism without any obvious clinic of PE in all cases with COVID-19, such cases should be screened for PE in the presence of significant D-dimer elevation.