Acute phase characteristics and long-term complications of pulmonary embolism in COVID-19 compared to non-COVID-19 cohort: a large single-centre study

BMC Pulmonary Medicine

Research Article

R. Pedrero-Tomé¹  C. Bibiano-Guillén²  M. Mir-Montero²  J. Bascuñana-Morejón de Girón³  D. Brown-Lavalle⁴  A. Franco-Moreno⁴  E. Fernández-Vidal⁴  E. Palma-Huerta⁴  A. Bustamante-Fermosel⁴  J. Torres-Macho⁴  S. Manzano-Valera⁴  N. Muñoz-Rivas⁴  B. Rodríguez-Gómez⁴  S. Estévez-Alonso⁴  M. Casado-Suela⁴  M. Campos-Arenas⁵  C. Muñoz-Roldán⁵  N. Rodríguez-Ramírez⁵  A. I. Rubio-Aguilera⁵ 

[1] EPINUT-UCM (Ref. 920325) Investigation Group, Universidad Complutense de Madrid, Madrid, Spain;Fundación para la Investigación e Innovación Biomédica de los Hospitales Universitarios Infanta Leonor y del Sureste, Madrid, Spain;Emergency Department, Hospital Universitario Infanta Leonor–Virgen de la Torre, Madrid, Spain;Internal Medicine Department, Hospital Universitario Doce de Octubre, Madrid, Spain;Internal Medicine Department, Hospital Universitario Infanta Leonor–Virgen de la Torre, Gran Via del Este Avenue, 80, 28031, Madrid, Spain;Radiology Department, Hospital Universitario Infanta Leonor–Virgen de la Torre, Madrid, Spain;

关键词: Case-control study;    COVID-19;    Pulmonary embolism;    Risk stratification;    Severity;    Long-term complications;   

DOI  :  10.1186/s12890-023-02323-9

 received in 2022-09-16, accepted in 2023-01-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death are valid in this population.MethodsWe retrospectively included hospitalized patients with PE from 1 January 2016 to 31 December 2022. Comparisons for acute episode characteristics, risk stratification of the PE, outcomes, and long-term complications were made between COVID and non-COVID patients.ResultsWe analyzed 116 (27.5%) COVID patients and 305 (72.4%) non-COVID patients. In patients with COVID-19, the traditional risk factors for PE were absent, and the incidence of deep vein thrombosis was lower. COVID patients showed significantly higher lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels. COVID patients had PE of smaller size (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental and 13.2% vs. 7.9% subsegmental, respectively; p < 0.001), less right ventricular dysfunction (7.7% vs. 17.7%; p = 0.007) and higher sPESI score (1.66 vs. 1.11; p < 0.001). The need for mechanical ventilation was significantly higher in COVID patients (8.6% vs. 1.3%; p < 0.001); However, the in-hospital death was less (5.2% vs. 10.8%; p = 0.074). The incidence of long-term complications was lower in COVID cohort (p < 0.001). PE severity assessed by high sPESI and intermediate and high-risk categories were independently associated with in-hospital mortality in COVID patients.ConclusionThe risk of in-hospital mortality and the incidence of long-term complications were lower in COVID-19. The usual tools for risk stratification of PE are valid in COVID patients.

【 授权许可】

CC BY   
© The Author(s) 2023

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