Pulmonary thromboembolism in severe COVID 19 pneumonia

Background: A high prevalence of pulmonary thromboembolism has been reported in severe COVID patient in Intensive care unit (ICU). Here in we review incidence and outcome of pulmonary thromboembolism in about 2500 COVID positive patients admitted in our institution. Aim and Objective: To identify the incidence and clinical outcome of pneumothorax in COVID-19 patients. Methods: We performed a retrospective review of COVID-19 cases admitted to our hospital. Patients who were diagnosed with pulmonary thromboembolism were identified to calculate the incidence of this event. Their clinical characteristics were thoroughly documented. Including their clinical outcomes. Results: Two thousand nine hundred ninety-six Covid -19 positive patients were admitted to our institution between January 1st, 2021 and, December 2021 out of which 1829 patients had moderate to severe disease. 32 cases of severe COVID-19 patients who developed pulmonary embolism during admission were identified. Conclusion: These cases suggest that pulmonary thromboembolism is a complication of COVID 19 early clinical signs of pulmonary embolism should be identified and DVT prophylaxis should be started early in moderate to severe disease.

Clinical and radiological outcomes of recovered covid-19 patients- an observational study during the early phase of the pandemic

Introduction: The pandemic caused by the Coronavirus Disease 2019 (COVID-19) has caused huge economic and health crisis. It is reported to have pulmonary sequelae which can overburden the healthcare systems. Survivors needing medical attention in the form of pulmonary rehabilitation should be prioritised. Aim: To study the impact of COVID-19 infection in terms of the pulmonary and extrapulmonary sequelae. Materials and Methods: This prospective observational study was carried out at a tertiary hospital in India. Recovered COVID-19 patients who were admitted from April to July 2020 were enrolled. Participants with radiological evidence of pneumonia during hospitalisation were assessed two months post-discharge. They were evaluated for persistent symptomatology, chest radiography, Six-Minute Walk Test (6MWT). The relationship between the outcome parameters with the baseline epidemiology, laboratory and radiology were evaluated by using student t-test, Mann-Whitney U test and multivariate logistic regression analysis. Results: Thirty participants were recruited. Their mean age was 47.93 years. Males were more than females. Persistent symptoms were reported by 17 (56.66%) and four (13.33%) developed pulmonary fibrosis on Chest X-Ray (CXR). Prolonged hospitalisation (mean >20 days) strongly correlated to the fibrosis (p=0.022). A fall in the finger oxygen saturation after the 6MWT was significant (p≤0.001). Higher serum levels of lactate dehydrogenase and D-dimer were associated with a more severe disease (p=0.02 and p≤0.001, respectively). Conclusion: Convalescent phase of COVID-19 is characterised by persistent symptomatology in half of the recovered patients. Simple and inexpensive CXRs and the 6MWT can be used as the primary investigation to identify post COVID-19 patients requiring pulmonary rehabilitation in resource limited settings.