Acute Pulmonary Embolism In Non-Hospitalized Covid-19 Patients Referred To CTPA By Emergency Department (preprint)

ABSTRACT

Objectives: To evaluate the prevalence of acute pulmonary embolism (APE) in non-hospitalized COVID-19 patients referred to CT pulmonary angiography (CTPA) by Emergency Department.Methods: From March 14 to April 6, 2020, 72 non-hospitalized patients referred by Emergency Department to CTPA for COVID-19 pneumonia were retrospectively identified. Relevant clinical and laboratory data and CT scan findings were collected for each patient. CTPA scans were reviewed by two radiologists to determinate the presence or absence of APE. Clinical classification, lung involvement of COVID-19 pneumonia and CT total severity score were compared between APE group and Non-APE group.Results: APE was identified in 13 (18%) CTPA scans. The mean age and D-dimer of patients from APE group were higher in comparison with Non-APE group (74.4 vs. 59.6 years, p=0.008 and 7.29 vs. 3.29 µg/ml, p=0.011). There was no significant difference between APE and Non-APE groups concerning clinical type, COVID-19 pneumonia lung lesions (ground-glass opacity 85 vs. 97%; consolidation 69 vs. 68%; crazy paving 38% vs. 37%; linear reticulation 69 vs. 78%), CT severity score (6.3 vs. 7.1, p=0.365), quality of CTPA (1.8 vs. 2.0, p=0.518) and pleural effusion (38% vs. 19%, p=0.146).Conclusions: Non-hospitalized patients with COVID-19 pneumonia referred to CT-scan by Emergency Departments are at risk of APE. Presence of APE was not limited to severe or critical clinical type of COVID-19 pneumonia.