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Pulmonary embolism in COVID-19 patients: prevalence, predictors and clinical outcome.
- Source :
-
Thrombosis research [Thromb Res] 2021 Feb; Vol. 198, pp. 34-39. Date of Electronic Publication: 2020 Nov 17. - Publication Year :
- 2021
-
Abstract
- Introduction: The incidence, characteristics, and prognosis of pulmonary embolism (PE) in Coronavirus disease 2019 (COVID-19) have been poorly investigated. We aimed to investigate the prevalence and the correlates with the occurrence of PE as well as the association between PE and the risk of mortality in COVID-19.<br />Methods: Retrospective multicenter study on consecutive COVID-19 patients hospitalized at 7 Italian Hospitals. At admission, all patients underwent medical history, laboratory and echocardiographic evaluation.<br />Results: The study population consisted of 224 patients (mean age 69 ± 14, male sex 62%); PE was diagnosed in 32 cases (14%). Patients with PE were hospitalized after a longer time since symptoms onset (7 IQR 3-11 days, 3 IQR 1-6 days; p = 0.001) and showed higher D-dimers level (1819 IQR 568-5017 ng/ml vs 555 IQR 13-1530 ng/ml; p < 0.001) and higher prevalence of myocardial injury (47% vs 28%, p = 0.033). At multivariable analysis, tricuspid annular plane systolic excursion (TAPSE; HR = 0.84; 95% CI 0.66-0.98; p = 0.046) and systolic pulmonary arterial pressure (sPAP; HR = 1.12; 95% CI 1.03-1.23; p = 0.008) resulted the only parameters independently associated with PE occurrence. Mortality rates (50% vs 27%; p = 0.010) and cardiogenic shock (37% vs 14%; p = 0.001) were significantly higher in PE as compared with non-PE patients. At multivariate analysis PE was significant associated with mortality.<br />Conclusion: PE is relatively common complication in COVID-19 and is associated with increased mortality risk. TAPSE and sPAP resulted the only parameters independently associated with PE occurrence in COVID-19 patients.<br /> (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
COVID-19 diagnosis
COVID-19 mortality
COVID-19 therapy
Female
Humans
Hypertension, Pulmonary epidemiology
Italy epidemiology
Male
Middle Aged
Prevalence
Prognosis
Pulmonary Embolism diagnosis
Pulmonary Embolism mortality
Pulmonary Embolism therapy
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Ventricular Dysfunction, Right epidemiology
COVID-19 epidemiology
Pulmonary Embolism epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-2472
- Volume :
- 198
- Database :
- MEDLINE
- Journal :
- Thrombosis research
- Publication Type :
- Report
- Accession number :
- 33271421
- Full Text :
- https://doi.org/10.1016/j.thromres.2020.11.017