Abstract
Objective: To determine the predictive factors of pulmonary thromboembolic (PTE) in patients with SARS-CoV-2 infection (COVID-19) assessed in the emergency department at a tertiary hospital during the first pandemic wave.
Methods: Observational single-center study conducted in a retrospective cohort of patients with confirmed SARS-CoV-2 infection (or high clinical-radiological suspicion) who underwent PTE screening by computed tomography pulmonary angiography (CTPA). Predictive factors of PTE were explored using logistic regression, creating two predictive models (without or with D-dimer values).
Results: Out of a total of 274 CTPA performed, 70 procedures presented diagnostic findings of PTE, representing a cumulative incidence of 25.54% (95% confidence interval [CI]: 20.49-31.14). In the non-D-dimer based model, respiratory rate>22bpm (odds ratio [OR]: 3.162; 95% CI: 1.627-6.148; p=0.001) and the absence of findings suggestive of COVID-19 in plain chest X-ray (OR: 3.869; 95% CI: 0.869-17.225; p=0.076) were predictors of PTE. In the D-dimer-based model, tachypnea remained as a predictive factor (OR: 4.967; 95% CI: 2.053-12.018; p<0.001), as well as D-dimers>3,000ng/ml (OR: 7.494; 95% CI: 3.038-18.485; p<0.001).
Conclusions: The presence of tachypnea (>22bpm) and the absence of radiological findings suggestive of SARS-CoV-2 infection in the chest X-ray, in addition to D-dimer values>3,000 ng/mL, were identified as predictive factors of PTE in patients with COVID-19.
Keywords: Agentes anticoagulantes; Angiografía pulmonar por tomografía computarizada; Anticoagulant agents; COVID-19; Computed tomography pulmonary angiography; Critical illness; D-dimer; Dímero D; Embolia pulmonar; Enfermedad crítica; Pulmonary embolism.
【저자키워드】 COVID-19, Critical illness, D-dimer, Pulmonary embolism, Embolia pulmonar, Agentes anticoagulantes, Angiografía pulmonar por tomografía computarizada, Anticoagulant agents, Computed tomography pulmonary angiography, Dímero D, Enfermedad crítica, 【초록키워드】 pandemic, SARS-COV-2 infection, hospital, Infection, diagnostic, tomography, Computed tomography, Predictive model, Pulmonary embolism, Patient, Logistic regression, chest X-ray, predictor, incidence, Odds ratio, CTPA, Predictive, pulmonary angiography, tachypnea, thromboembolic, Factor, 95% confidence interval, D-dimer values, single-center study, cumulative, retrospective cohort, radiological finding, performed, addition, remained, conducted, determine, absence, representing, creating, patients with COVID-19, patients with SARS-CoV-2, 【제목키워드】 Infection, prediction, patients with SARS-CoV-2,