1. CT imaging of pulmonary embolism in patients with COVID-19 pneumonia: a retrospective analysis.
- Author
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Espallargas I, Rodríguez Sevilla JJ, Rodríguez Chiaradía DA, Salar A, Casamayor G, Villar-Garcia J, Rodó-Pin A, Marsico S, Carbullanca S, Ramal D, Del Carpio LA, Gayete Á, Maiques JM, and Zuccarino F
- Subjects
- Humans, Retrospective Studies, SARS-CoV-2, Tomography, X-Ray Computed, COVID-19, Pulmonary Embolism diagnostic imaging
- Abstract
Objectives: To describe imaging and laboratory findings of confirmed PE diagnosed in COVID-19 patients and to evaluate the characteristics of COVID-19 patients with clinical PE suspicion. Characteristics of patients with COVID-19 and PE suspicion who required admission to the intensive care unit (ICU) were also analysed., Methods: A retrospective study from March 18, 2020, until April 11, 2020. Inclusion criteria were patients with suspected PE and positive real-time reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Exclusion criteria were negative or inconclusive RT-PCR and other chest CT indications. CTPA features were evaluated and severity scores, presence, and localisation of PE were reported. D-dimer and IL-6 determinations, ICU admission, and previous antithrombotic treatment were registered., Results: Forty-seven PE suspicions with confirmed COVID-19 underwent CTPA. Sixteen patients were diagnosed with PE with a predominant segmental distribution. Statistically significant differences were found in the highest D-dimer determination in patients with PE and ICU admission regarding elevated IL-6 values., Conclusion: PE in COVID-19 patients in our series might predominantly affect segmental arteries and the right lung. Results suggest that the higher the D-dimer concentration, the greater the likelihood of PE. Both assumptions should be assessed in future studies with a larger sample size., Key Points: • On CT pulmonary angiography, pulmonary embolism in COVID-19 patients seems to be predominantly distributed in segmental arteries of the right lung, an assumption that needs to be approached in future research. • Only the highest intraindividual determination of d-dimer from admission to CT scan seems to differentiate patients with pulmonary embolism from patients with a negative CTPA. However, interindividual variability calls for future studies to establish cut-off values in COVID-19 patients. • Further studies with larger sample sizes are needed to determine whether the presence of PE could increase the risk of intensive care unit (ICU) admission in COVID-19 patients.
- Published
- 2021
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