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.
Keywords: COVID-19; Computed tomography; Inflammation; Pulmonary embolism; Thrombosis.
【저자키워드】 COVID-19, Inflammation, thrombosis, Computed tomography, Pulmonary embolism, 【초록키워드】 Hospitalized, Hospitalization, prospective observational study, hospital, risk, D-dimer, risk factor, pulmonary, oxygen saturation, Cohort, Characteristics, COVID-19 infection, Patient, Spain, heart rate, incidence, Admission, Multivariate analysis, Thromboprophylaxis, D-dimer level, exclusion criteria, Predictive, pulmonary angiography, C-reactive protein (CRP, hospitalized COVID-19 patients, 95% confidence interval, clinical suspicion, hazard, inclusion criteria, thrombotic, CRP level, variable, pharmacological, Randomly, Valencia, selected, performed, elevated, determine, Ratio, baseline, consecutive patient, eligible patient, independent predictor, patients hospitalized, 【제목키워드】 Risk factors, COVID-19 infection, thrombotic, patients hospitalized,