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Pulmonary embolism severity before and during the COVID-19 pandemic.
Tilliridou, Vicky; Kirkbride, Rachael; Dickinson, Rebecca; Tiernan, James; Yong, Guo Liang; van Beek, Edwin Jr; Murchison, John T; Williams, Michelle Claire.
  • Tilliridou V; Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Kirkbride R; Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Dickinson R; Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Tiernan J; Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Yong GL; Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • van Beek EJ; Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK.
  • Murchison JT; Edinburgh Imaging, University of Edinburgh, Edinburgh, UK.
  • Williams MC; Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK.
Br J Radiol ; 94(1123): 20210264, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1262534
ABSTRACT

OBJECTIVES:

Early in the coronavirus 2019 (COVID-19) pandemic, a high frequency of pulmonary embolism was identified. This audit aims to assess the frequency and severity of pulmonary embolism in 2020 compared to 2019.

METHODS:

In this retrospective audit, we compared computed tomography pulmonary angiography (CTPA) frequency and pulmonary embolism severity in April and May 2020, compared to 2019. Pulmonary embolism severity was assessed with the Modified Miller score and the presence of right heart strain was assessed. Demographic information and 30-day mortality was identified from electronic health records.

RESULTS:

In April 2020, there was a 17% reduction in the number of CTPA performed and an increase in the proportion identifying pulmonary embolism (26%, n = 68/265 vs 15%, n = 47/320, p < 0.001), compared to April 2019. Patients with pulmonary embolism in 2020 had more comorbidities (p = 0.026), but similar age and sex compared to 2019. There was no difference in pulmonary embolism severity in 2020 compared to 2019, but there was an increased frequency of right heart strain in May 2020 (29 vs 12%, p = 0.029). Amongst 18 patients with COVID-19 and pulmonary embolism, there was a larger proportion of males and an increased 30 day mortality (28% vs 6%, p = 0.008).

CONCLUSION:

During the COVID-19 pandemic, there was a reduction in the number of CTPA scans performed and an increase in the frequency of CTPA scans positive for pulmonary embolism. Patients with both COVID-19 and pulmonary embolism had an increased risk of 30-day mortality compared to those without COVID-19. ADVANCES IN KNOWLEDGE During the COVID-19 pandemic, the number of CTPA performed decreased and the proportion of positive CTPA increased. Patients with both pulmonary embolism and COVID-19 had worse outcomes compared to those with pulmonary embolism alone.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Embolism / Computed Tomography Angiography / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Br J Radiol Year: 2021 Document Type: Article Affiliation country: Bjr.20210264

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Embolism / Computed Tomography Angiography / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Br J Radiol Year: 2021 Document Type: Article Affiliation country: Bjr.20210264