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Incidence, risk factors, and thrombotic load of pulmonary embolism in patients hospitalized for COVID-19 infection

2021; Elsevier BV; Volume: 82; Issue: 2 Linguagem: Inglês

10.1016/j.jinf.2021.01.003

1532-2742

Alberto García‐Ortega, Grace Oscullo, Pilar Calvillo, Raquel López‐Reyes, Raúl Méndez, José Daniel Gómez-Olivas, Amina Bekki, Carles Fonfría, Laura Trilles-Olaso, Enrique Zaldívar, Ana Ferrando, Gabriel Anguera, Andrés Briones-Gómez, Juan Pablo Reig-Mezquida, Laura Feced, Paula González‐Jiménez, Soledad Reyes, Carlos Francisco Muñoz-Núñez, Ainhoa Carreres, R. Romero Gil, Carmen Morata, Nuria Toledo‐Pons, Luis Martí‐Bonmatí, Rosario Menéndez, Miguel Ángel Martínez‐García,

COVID-19 and healthcare impacts

To determine the incidence, characteristics, and risk factors of pulmonary embolism (PE) among patients hospitalized for COVID-19.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.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).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.