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Acute pulmonary embolism in COVID-19 disease: Preliminary report on seven patients.
Faggiano, Pompilio; Bonelli, Andrea; Paris, Sara; Milesi, Giuseppe; Bisegna, Stefano; Bernardi, Nicola; Curnis, Antonio; Agricola, Eustachio; Maroldi, Roberto.
  • Faggiano P; Cardiology Unit, Spedali Civili and University of Brescia, Italy. Electronic address: cardiologia@pompiliofaggiano.it.
  • Bonelli A; Cardiology Unit, Spedali Civili and University of Brescia, Italy.
  • Paris S; Cardiology Unit, Spedali Civili and University of Brescia, Italy.
  • Milesi G; Cardiology Unit, Spedali Civili and University of Brescia, Italy.
  • Bisegna S; Cardiology Unit, Spedali Civili and University of Brescia, Italy.
  • Bernardi N; Cardiology Unit, Spedali Civili and University of Brescia, Italy.
  • Curnis A; Cardiology Unit, Spedali Civili and University of Brescia, Italy.
  • Agricola E; Cardiovascular Imaging Unit, San Raffaele Hospital and University, Milan, Italy.
  • Maroldi R; Department of Radiological Sciences, Spedali Civili and University of Brescia, Italy.
Int J Cardiol ; 313: 129-131, 2020 08 15.
Article in English | MEDLINE | ID: covidwho-259358
ABSTRACT
There is some evidence that Covid 19 pneumonia is associated with prothrombotic status and increased risk of venous thromboembolic events (deep venous thrombosis and pulmonary embolism). Over a two-week period we admitted in our Unit 25 patients with Covid-19 pneumonia, of these pulmonary embolism was diagnosed using computed tomography angiography in 7. We report on clinical and biochemical features of these patients. They were all males, with a mean age of 70.3 years (range 58-84); traditional risk factors for venous thromboembolism were identified in the majority of patients with pulmonary embolism, however not differently from those without pulmonary embolism. Clinical presentation of pulmonary embolism patients was usually characterized by persistence or worsening of respiratory symptoms, with increasing oxygen requirement. D-dimer levels were several fold higher than the upper threshold of normal; in patients in whom PE was recognized during hospital stay, a rapid and relevant increase of D-dimer levels was observed. Computed tomographic findings ranged from massive acute pulmonary embolism to a segmental or sub-segmental pattern; furthermore, thrombosis of sub-segmental pulmonary arteries within lung infiltrates were occasionally seen, suggesting local mechanisms. Six out of 7 patients were treated with unfractionated or low molecular weight heparin with clinical benefit within few days; one patient needed systemic thrombolysis (death from hemorrhagic complication).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Pulmonary Embolism / Fibrin Fibrinogen Degradation Products / Heparin / Coronavirus Infections / Venous Thromboembolism / Pandemics Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Country/Region as subject: Europa Language: English Journal: Int J Cardiol Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Pulmonary Embolism / Fibrin Fibrinogen Degradation Products / Heparin / Coronavirus Infections / Venous Thromboembolism / Pandemics Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Country/Region as subject: Europa Language: English Journal: Int J Cardiol Year: 2020 Document Type: Article