PULMONARY EMBOLISM RISK STRATIFICATION IN PATIENTS WITH COVID-19 AND ACUTE PULMONARY EMBOLISM

ABSTRACT

SESSION TITLE Acute COVID-19 and Beyond from Hospital to Homebound SESSION TYPE Original Investigations PRESENTED ON 10/18/22 245 pm - 345 pm PURPOSE: Coronavirus-19 (COVID-19) infection associated hypercoagulability places patients at a risk of developing of pulmonary embolism (PE) [1]. This study aims to determine the utility of traditional risk stratification tools in this patient population. METHODS: This is a retrospective analysis of non-pregnant patients, >=18 years admitted to UPMC Community Osteopathic and UPMC West Shore Hospitals with acute PE between September 2019 and June 2021. We used Student’s t-test to analyze group differences, Welch-Satterthwaite t-test for the unequal continuous data, and chi-square test to analyze group differences for the categorical variables. RESULTS: A total of 309 patients were included (52 patients diagnosed with COVID-19, and 115 patients tested negative. 142 patients were not tested and hence not included in the analysis. The mean age was 61.7 years in COVID-19 patients and 63.8 years in non-COVID-19 patients. There was no difference in the severity of PE when classified as massive (1.92% vs 3.48%, p=1.0000), sub-massive (17.31% vs 29.57%, p=0.0934), non-massive (88.77% vs 66.96%, p=0.0678). No difference was seen in shock index (0.5-0.7 73.08% vs 66.09%;>0.8 26.92% vs 33.91%, (p=0.3688)). PESI score was also similar with PESI Class I 25% vs 21.74%, Class II 21.15% vs 17.39%, Class III 21.15% vs 26.96%, class IV 19.23% vs 13.04%, Class V 13.36% vs 20.87% (p=0.5757). Simplified PESI identifying PE risk was similar in groups with high risk in 56.86% vs 66.09%, and low risk in 43.14% vs 33.91% (p=0.1734). No difference was seen in the outcomes of COVID-19 vs non-COVID-19 patients including the length of hospital stay (<1 day 21.15% vs 12.17%, p=0.1230;>=6 days 21.15% vs 32.17%, p=0.1451) and ICU admission (11.54% vs 20%, p=0.1813). There was no difference in the occurrence of right heart strain (21.15% vs 32.17%, p=0.1451), saddle PE (5.77% vs 6.09%, p=1), and intubation (0% vs 1.74%, p=1.0000). Mortality rate was similar (5.77% vs 0.87%, p=0.0900). Readmission rate at 30 days was higher in non-COVID-19 patients at 30 days (9.62% vs 24.35%, p=0.0268) with no difference at 3 months (5.77% vs 6.09%, p=1.0000). Differences in laboratory findings in COVID-19 vs non-COVID-19 patients included BNP>100 (20% vs 38.46%, p=0.0276) and elevated troponin level > 0.03 (26% vs 42.86%, p=0.0408) which were more frequently observed in COVID-19. CONCLUSIONS: Our study is limited in the sense that it is retrospective in nature, and we assessed the patient population admitted to 2 of our hospitals. Despite the lab studies discrepancies in troponin and BNP levels, PE in COVID-19 patients was not associated with fatal or near fatal outcomes as compared to non-COVID-19 patients. CLINICAL IMPLICATIONS Scoring metrics including Shock Index and PESI along with sPESI scoring systems, if utilized, can help with management and decrease length of stay among COVID-19 and non-COVID-19 patients with pulmonary embolism. DISCLOSURES No relevant relationships by Ahmed Aladham No relevant relationships by Konstantin Golubykh No relevant relationships by Iuliia Kovalenko No relevant relationships by Kriti Lnu No relevant relationships by Navitha Ramesh No relevant relationships by Yijin Wert