ABSTRACT
Background Knowledge of predisposing factors in developing pulmonary thromboembolism (PTE) is important in the diagnosis and treatment approach. The association between past coronavirus disease-19 (COVID-19) infection and PTE is a potential research topic. In this study we aimed to determine the prevalence of previous COVID-19 in addition to all predisposing factors for PTE development and to determine whether there is a difference in embolism severity in these cases.Methods Study design: Multicenter, observational, cross-sectional. Patients diagnosed with PTE between March 11, 2022, and March 11, 2023, were prospectively included in the study. Group 1: PTE cases with previous COVID-19, Group 2: PTE cases without previous COVID-19. To compare the categorical variables between groups the chi-square test was used. For continuous variables, parametric and non-parametric tests were used. Multivariate binary logistic regression analysis was performed to determine the independent variables related to PTE severity that affected the presence of previous COVID-19.Results Forty-four researchers from 33 centers participated in our study. A total of 1185 patients were included (Group 1; n = 360, Group 2; n = 825). The median post-COVID duration was 120.0 (min-max: 30–980) days. Computed tomography pulmonary angiography (CTPA) right ventricle/left ventricle (RV/LV) ratio > 1 was significantly higher in Group 2 compared to Group 1 (27.9% vs 19.7%, p = 0.003).The proportion of patients receiving systemic thrombolytic drugs (11.3% vs. 7.5%, p = 0.048), and the rate of patients who started treatment in the intensive care unit was higher in Group 2 (23.4% vs. 14.7%, p = 0.001). In multivariate logistic regression analysis, the absence of any identifiable risk factor for PTE was found to be a 0.46-fold protective factor in the presence of previous COVID-19 (95% CI: 0.274–0.760, p = 0.003) and an RV/LV ratio > 1 on CTPA was found to be a 0.60-fold protective factor (95% CI: 0.365–0.998, p = 0.049).Conclusions The prevalence of previous COVID-19 infection in PTE cases was 30.4%, and 26% of idiopathic cases had previous COVID-19 infection. Although the parameters related to embolism severity were higher in the non-COVID-19 group, in multivariate analyses, only idiopathic status was associated with a 2.2-fold increased risk in non-COVID-19 patients compared to those who had, and an RV/LV ratio > 1 on CTPA was associated with a 1.7-fold increased risk.
Subject(s)
COVID-19 , Embolism , Pulmonary EmbolismABSTRACT
Background: Today, COVID-19 pandemic has brought countries' health services into sharp focus. Despite the low incidence of cases(1.2%) and high mortality rate(2.4%) among Turkish population, the low mortality rate(0.3%) despite the high incidence(11.5%) declared in healthcare workers drew our group's attention. Therefore, we aimed to report the characteristics of infected health-care workers and investigate the relationship between BCG vaccine and tuberculosis history with COVID-19 mortality in infected health-care worker population. Method: This study was conducted in three hospitals to assess the clinical presentations, disease severity and correlation with BCG vaccine and tuberculous history in COVID-19 positive health-care workers by an online questionnaire platform. The relationship between characteristics and tuberculosis history were investigated according to hospitalization status of the patients. Result: Total of 465 infected healthcare workers included in the study. The rate of history of direct care and contact to tuberculosis patient, presence of previous tuberculosis treatment and BCG scar, presence of radiological infiltrations was significantly higher in hospitalized healthcare workers. The ratio of direct care and direct contact to the patient with tuberculosis, and presence of family history of tuberculosis were statistically significantly higher in patients with radiological infiltrations. Conclusion: Although COVID-19 risk and incidence are higher among healthcare workers compared to the normal population due to higher virus load, we think that the lower mortality rate seen in infected healthcare workers results from healthcare workers' frequent exposure to tuberculosis bacillus and the mortality-reducing effects of BCG vaccine, despite the higher hospitalization rate and radiological infiltrations due to over-triggered immune system.