ABSTRACT
Pulmonary embolism (PE) is common among hospitalized adults with SARS CoV-2 pneumonia. D-dimer (DD)>1 mug/mL has been found to be a severity risk factor. However, most of the studies are based on retrospective data and the real prevalence is unknown Objectives: To evaluate the prevalence of PE in patients with SARS CoV-2 pneumonia, regardless clinical suspicion. Demographic and laboratory data, comorbidities, and clinical outcomes were compared between patients with and without PE Methods: Single-center prospective study. All consecutive cases of SARS CoV-2 pneumonia with DD>1 mug/mL underwent computed tomography pulmonary angiography Results: 179 patients (64 (55-74 years), 65% male) were included. PE was diagnosed in 71 patients (39.7%), mostly with a peripheral location and low thrombotic load (Qanadli score 10%). We did not find disparity in PE prevalence between men and women, and between obese and not obese patients. There were no differences in the intensive care unit admission rate. Mortality rate was 8.5% in patients with PE vs. 3.7% in those without PE, but the differences were not significant. Patients with PE had more history of cardiovascular disease and required more fractional inspired oxygen. DD, platelet distribution width (PDW), neutrophil-lymphocyte ratio (NLR), DD-lactate dehydrogenase ratio (DD/LDH), and DD-ferritin ratio values were significantly higher among PE patients. ROC analysis showed that PDW and DD/LDH had the greatest area under the curve Conclusion(s): Patients with SARS CoV2 pneumonia and DD>1mug/mL presented a high prevalence of PE, regardless of clinical suspicion. PDW, NLR, DD/LDH and DD/Ferritin may help to identify patients with high risk of PE.
ABSTRACT
BACKGROUND: Development of methodologies to quantify airborne micro-organisms is needed for the prevention and control of infections. It is difficult to conclude which is the most efficient and sensitive strategy to assess airborne SARS-CoV-2 RNA levels due to the disparity of results reported in clinical settings. AIM: To improve our previously reported protocol of measuring SARS-CoV-2 RNA levels, which was based on bioaerosol collection with a liquid impinger and RNA quantification with droplet digital polymerase chain reaction (ddPCR). METHODS: Air samples were collected in COVID-19 patient rooms to assess efficiency and/or sensitivity of different air samplers, liquid collection media, and reverse transcriptases (RT). FINDINGS: Mineral oil retains airborne RNA better than does hydrophilic media without impairing integrity. SARS-CoV-2 ORF1ab target was detected in 80% of the air samples using BioSampler with mineral oil. No significant differences in effectiveness were obtained with MD8 sampler equipped with gelatine membrane filters, but the SARS-CoV-2 copies/m3 air obtained with the latter were lower (28.4 ± 6.1 vs 9 ± 1.7). SuperScript II RT allows the detection of a single SARS-CoV-2 genome RNA molecule by ddPCR with high efficiency. This was the only RT that allowed the detection of SARS-CoV-2 N1 target in air samples. CONCLUSION: The collection efficiency and detection sensivity of a protocol to quantify SARS-CoV-2 RNA levels in indoor air has been improved in the present study. Such optimization is important to improve our understanding of the microbiological safety of indoor air.