CHRONIC THROMBOEMBOLIC DISEASE AFTER ACUTE PULMONARY EMBOLISM RELATED TO SARSCoV-2

ABSTRACT

During SARS-CoV-2 infection, acute pulmonary embolism (PE) worsens the patient's clinical status. However, after resolution of the acute phase, the impact of residual thrombotic lesions in pulmonary vasculature remains unknown. In this line, chronic thromboembolic disease (CTD) consists of persistent thrombotic lesions and involves long-term functional limitations, including those for patients with a CTD with or without chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to evaluate the prevalence of CTD after hospitalization for SARSCoV-2 pneumonia and PE. Also, we evaluated the clinical and functional characteristics of these patients. Forty-two patients diagnosed of PE in the course of SARS-CoV-2 pneumonia were included. In all patients, CT angiography (n=35) and/or pulmonary V/Q scan (n=19) was obtained between 3 to 4 months after discharge. Remaining symptoms, pulmonary function and exercise capacity also were evaluated. Eleven patients (26%) showed persistent thrombotic lesions without residual SARS-CoV-2 pneumonia images. Within this former group, 36% (n=4) had exertional dyspnea as expression of CTD. Only one patient (9%) developed CTEPH. The only related factor with persistent thrombotic lesions was older age (>70 years). Exercise capacity and pulmonary function were not significantly different between symptomatic and non-symptomatic patients. Residual thrombotic lesions are a frequent finding after SARS-CoV-2 infection, however the prevalence of CTD and CTEPH are similar to SARS-CoV-2 non-related acute pulmonary embolism. In this patients, the current recommendations for pulmonary embolism monitoring after discharge could be applied.