Predictors of pulmonary embolism in hospitalized patients with COVID-19

Thrombosis Journal

Research

Rowena Yip¹  Jiafang Zhang¹  Bharat Narasimhan²  Kam Sing Ho²  Jeeyune Bahk²  Abdul Rehman³  Robert Lookstein⁴  Hafiza Noor Ul Ain Baloch⁵  David J Steiger⁵ 

[1] Department of Biostatistics, Mount Sinai West and Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA;Department of Medicine, Mount Sinai Morningside and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY, USA;Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ, ISA, USA;Department of Radiology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA;Division of Pulmonary and Critical Care, Department of Medicine, Mount Sinai West and Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, 10019, New York, NY, USA;

关键词: Pulmonary embolism;    Venous Thromboembolism;    Coagulopathy;    D-dimer;    Coronavirus disease 2019;   

DOI  :  10.1186/s12959-023-00518-y

 received in 2023-04-12, accepted in 2023-06-24,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHigh venous thromboembolism (VTE) rates have been described in critically ill patients with COVID-19. We hypothesized that specific clinical characteristics may help differentiate hypoxic COVID-19 patients with and without a diagnosed pulmonary embolism (PE).MethodsWe performed a retrospective observational case-control study of 158 consecutive patients hospitalized in one of four Mount Sinai Hospitals with COVID-19 between March 1 and May 8, 2020, who received a Chest CT Pulmonary Angiogram (CTA) to diagnose a PE. We analyzed demographic, clinical, laboratory, radiological, treatment characteristics, and outcomes in COVID-19 patients with and without PE.Results92 patients were negative (CTA-), and 66 patients were positive for PE (CTA+). CTA + had a longer time from symptom onset to admission (7 days vs. 4 days, p = 0.05), higher admission biomarkers, notably D-dimer (6.87 vs. 1.59, p < 0.0001), troponin (0.015 vs. 0.01, p = 0.01), and peak D-dimer (9.26 vs. 3.8, p = 0.0008). Predictors of PE included time from symptom onset to admission (OR = 1.11, 95% CI 1.03–1.20, p = 0.008), and PESI score at the time of CTA (OR = 1.02, 95% CI 1.01–1.04, p = 0.008). Predictors of mortality included age (HR 1.13, 95% CI 1.04–1.22, p = 0.006), chronic anticoagulation (13.81, 95% CI 1.24–154, p = 0.03), and admission ferritin (1.001, 95% CI 1-1.001, p = 0.01).ConclusionsIn 158 hospitalized COVID-19 patients with respiratory failure evaluated for suspected PE, 40.8% patients had a positive CTA. We identified clinical predictors of PE and mortality from PE, which may help with early identification and reduction of PE-related mortality in patients with COVID-19.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023. corrected publication 2023

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