Abstract
ABSTRACT Objective To determine the incidence, characteristics, and risk factors of pulmonary embolism (PE) among patients hospitalized for COVID-19 Patients and Methods 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 Results 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) Conclusions 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
Study details
Credits : Bibliographic data from Global Research on Coronavirus Disease (COVID-19) Database: World Health Organisation, Creative Commons Licence CC BY-NC-SA 3.0 IGO.