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Clin Appl Thromb Hemost ; 26: 1076029620936772, 2020.
Article in English | MEDLINE | ID: covidwho-690346


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.

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