Characteristics of Acute Pulmonary Embolism in Patients With COVID-19 Associated Pneumonia From the City of Wuhan.

Abstract

The aim of this study was to describe clinical, imaging, and laboratory features of acute pulmonary embolism (APE) in patients with COVID-19 associated pneumonia. Patients with COVID-19 associated pneumonia who underwent a computed tomography pulmonary artery (CTPA) scan for suspected APE were retrospectively studied. Laboratory data and CTPA images were collected. Imaging characteristics were analyzed descriptively. Laboratory data were analyzed and compared between patients with and without APE. A series of 25 COVID-19 patients who underwent CTPA between January 2020 and February 2020 were enrolled. The median D-dimer level founded in these 25 patients was 6.06 μg/mL (interquartile range [IQR] 1.90-14.31 μg/mL). Ten (40%) patients with APE had a significantly higher level of D-dimer (median, 11.07 μg/mL; IQR, 7.12-21.66 vs median, 2.44 μg/mL; IQR, 1.68-8.34, respectively, P = .003), compared with the 15 (60%) patients without APE. No significant differences in other laboratory data were found between patients with and without APE. Among the 10 patients with APE, 6 (60%) had a bilateral pulmonary embolism, while 4 had a unilateral embolism. The thrombus-prone sites were the right lower lobe (70%), the left upper lobe (60%), both upper lobe (40%) and the right middle lobe (20%). The thrombus was partially or completely absorbed after anticoagulant therapy in 3 patients who underwent a follow-up CTPA. Patients with COVID-19 associated pneumonia have a risk of developing APE during the disease. When the D-dimer level abnormally increases in patients with COVID-19 pneumonia, CTPA should be performed to detect and assess the severity of APE.

• Authors: Jianpu Chen, Xiang Wang, Shutong Zhang, Bin Lin, Xiaoqing Wu, Yanfang Wang, Xiaoqi Wang, Ming Yang, Jianqing Sun, Yuanliang Xie
• Journal: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis (Clin Appl Thromb Hemost) 2020 Jan-Dec Vol. 26 Pg. 1076029620936772 ISSN: 1938-2723 [Electronic] United States
• PMID: 32726134 (Publication Type: Journal Article)

Chemical References

• Anticoagulants
• Fibrin Fibrinogen Degradation Products
• fibrin fragment D

Topics

• Acute Disease
• Adult
• Aged
• Anticoagulants (therapeutic use)
• Betacoronavirus (pathogenicity)
• COVID-19
• Computed Tomography Angiography (methods)
• Coronavirus Infections (blood, complications, diagnostic imaging, virology)
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• Humans
• Male
• Middle Aged
• Pandemics
• Pneumonia, Viral (blood, complications, diagnostic imaging, virology)
• Pulmonary Artery (anatomy & histology, diagnostic imaging, virology)
• Pulmonary Embolism (blood, diagnostic imaging, etiology, virology)
• Retrospective Studies
• SARS-CoV-2
• Thrombosis (drug therapy)
• Tomography, X-Ray Computed (methods)