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- Title
CT imaging of pulmonary embolism in patients with COVID-19 pneumonia: a retrospective analysis.
- Authors
Espallargas, Irene; Rodríguez Sevilla, Juan José; Rodríguez Chiaradía, Diego Agustín; Salar, Antonio; Casamayor, Guillem; Villar-Garcia, Judit; Rodó-Pin, Anna; Marsico, Salvatore; Carbullanca, Santiago; Ramal, Diego; del Carpio, Luis Alexander; Gayete, Ángel; Maiques, José María; Zuccarino, Flavio
- 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 ofd-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.
- Subjects
COMPUTED tomography; COVID-19; PULMONARY embolism; INTENSIVE care units; FIBRIN fragment D
- Publication
European Radiology, 2021, Vol 31, Issue 4, p1915
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-020-07300-y