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High risk of pulmonary embolism in acute respiratory distress syndrome related to COVID-19: an observational controlled-cohort study.
de Roubin, Victor; Reynaud, Faustine; Coudroy, Rémi; Rodriguez, Maeva; Monseau, Grégoire; Joly, Florent; Bardin, Justine; Boissier, Florence; Chatellier, Delphine; Veinstein, Anne; Robert, René; Frat, Jean-Pierre; Thille, Arnaud W.
  • de Roubin V; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Reynaud F; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Coudroy R; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Rodriguez M; INSERM CIC 1402 ALIVE Research Group, University of Poitiers, Poitiers, France.
  • Monseau G; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Joly F; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Bardin J; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Boissier F; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Chatellier D; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Veinstein A; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Robert R; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Frat JP; Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
  • Thille AW; INSERM CIC 1402 ALIVE Research Group, University of Poitiers, Poitiers, France.
Ann Transl Med ; 9(8): 630, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1224386
Semantic information from SemMedBD (by NLM)
1. Pulmonary Embolism COEXISTS_WITH Respiratory Distress Syndrom
Subject
Pulmonary Embolism
Predicate
COEXISTS_WITH
Object
Respiratory Distress Syndrom
2. Respiratory Distress Syndrom COEXISTS_WITH C5203670
Subject
Respiratory Distress Syndrom
Predicate
COEXISTS_WITH
Object
C5203670
3. Increased risk COEXISTS_WITH COVID-19
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
COVID-19
4. Lung LOCATION_OF Respiratory Distress Syndrom
Subject
Lung
Predicate
LOCATION_OF
Object
Respiratory Distress Syndrom
5. Respiratory Distress Syndrom PROCESS_OF C0030705
Subject
Respiratory Distress Syndrom
Predicate
PROCESS_OF
Object
C0030705
6. Pulmonary Embolism OCCURS_IN Patients
Subject
Pulmonary Embolism
Predicate
OCCURS_IN
Object
Patients
7. Lung LOCATION_OF Computed Tomography Angiography
Subject
Lung
Predicate
LOCATION_OF
Object
Computed Tomography Angiography
8. Pulmonary Embolism PROCESS_OF Patients
Subject
Pulmonary Embolism
Predicate
PROCESS_OF
Object
Patients
9. Pulmonary Embolism COEXISTS_WITH COVID-19
Subject
Pulmonary Embolism
Predicate
COEXISTS_WITH
Object
COVID-19
10. Computed Tomography Angiography ADMINISTERED_TO Patients
Subject
Computed Tomography Angiography
Predicate
ADMINISTERED_TO
Object
Patients
11. Pulmonary Embolism COEXISTS_WITH Respiratory Distress Syndrome, Adult
Subject
Pulmonary Embolism
Predicate
COEXISTS_WITH
Object
Respiratory Distress Syndrome, Adult
12. Respiratory Distress Syndrome, Adult COEXISTS_WITH COVID-19
Subject
Respiratory Distress Syndrome, Adult
Predicate
COEXISTS_WITH
Object
COVID-19
13. Increased risk COEXISTS_WITH COVID-19
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
COVID-19
14. Lung LOCATION_OF Respiratory Distress Syndrome, Adult
Subject
Lung
Predicate
LOCATION_OF
Object
Respiratory Distress Syndrome, Adult
15. Respiratory Distress Syndrome, Adult PROCESS_OF Patients
Subject
Respiratory Distress Syndrome, Adult
Predicate
PROCESS_OF
Object
Patients
16. Pulmonary Embolism OCCURS_IN Patients
Subject
Pulmonary Embolism
Predicate
OCCURS_IN
Object
Patients
17. Lung LOCATION_OF Computed Tomography Angiography
Subject
Lung
Predicate
LOCATION_OF
Object
Computed Tomography Angiography
18. Pulmonary Embolism PROCESS_OF Patients
Subject
Pulmonary Embolism
Predicate
PROCESS_OF
Object
Patients
19. Pulmonary Embolism COEXISTS_WITH COVID-19
Subject
Pulmonary Embolism
Predicate
COEXISTS_WITH
Object
COVID-19
20. Computed Tomography Angiography ADMINISTERED_TO Patients
Subject
Computed Tomography Angiography
Predicate
ADMINISTERED_TO
Object
Patients
ABSTRACT

BACKGROUND:

COVID-19 may induce endovascular injury of pulmonary vessels and could be associated with increased risk of pulmonary embolism. The main objective was to compare the incidence of pulmonary embolism in patients with acute respiratory distress syndrome (ARDS) related to COVID-19 versus patients with pulmonary ARDS unrelated to COVID-19.

METHODS:

This is an observational controlled-cohort study performed at a single center of a university teaching hospital in France. The incidence of pulmonary embolism was prospectively assessed using computed tomography pulmonary angiography (CTPA) in patients with ARDS related to COVID-19 and compared to patients from a 3-year historical cohort of patients with pulmonary ARDS unrelated to COVID-19. In patients with ARDS related to COVID-19, CTPA was performed approximately 7 days after intubation or earlier in case of respiratory or hemodynamic worsening.

RESULTS:

CTPA was performed in 29 out of the 42 patients (69%) with ARDS related to COVID-19 and in 51 out of the 156 patients (33%) from the historical cohort of patients with pulmonary ARDS unrelated to COVID-19. Incidence of pulmonary embolism was 40% (17/42) in patients with ARDS related to COVID-19 and 3% (5/156) in the historical cohort (P=0.001). The proportion of patients with pulmonary embolism among all patients who had CTPA was 59% (17/29) in patients with ARDS related to COVID-19 and 10% (5/51) in the historical cohort (P=0.0001). After adjustment on the interval between ICU admission and computed tomography, COVID-19 remained independently associated with pulmonary embolism.

CONCLUSIONS:

Pulmonary embolism was particularly frequent in patients with ARDS related to COVID-19, thereby suggesting that CTPA should be systematically performed in these patients.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Risk factors Language: English Journal: Ann Transl Med Year: 2021 Document Type: Article Affiliation country: Atm-20-6796

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Risk factors Language: English Journal: Ann Transl Med Year: 2021 Document Type: Article Affiliation country: Atm-20-6796