Elevated D-Dimer and acute pulmonary embolism in COVID-19 patients / Dímero-D elevado y tromboembolismo pulmonar agudo en pacientes con COVID-19

ABSTRACT

INTRODUCTION: It has been determined that patients with SARS-CoV-2 infection and severe pneumonia with elevated D-dimer values ​​can develop acute pulmonary thromboembolism (APE) as a complication, being one of the causes related to mortality in this group of patients. METHODS: A retrospective analysis of 12 patients diagnosed with SARS-CoV-2 infection with high clinical suspicion of APE confirmed by computed tomography pulmonary angiopgraphy (CTPA) was performed and the described findings are described. RESULTS: 12 patients with diagnosis of severe pneumonia, elevated D-dimer 9.2 μg / ml (1.4 - ˃20 μg / mL) and confirmation of SARS-CoV-2 infection through real-time reverse transcription polymerasa chain reaction (RT-PCR). APEs were observed mainly in segmental arteries (75%) and main arteries (25%). Pneumonia with patched areas of bilateral ground glass opacities was observed in 100% of the sample as a typical finding of SARS-CoV-2 infection. CONCLUSION: SARS-CoV-2 infection is related to elevation of D-dimer and APE. The CTPA determines the diagnosis, severity and timely management (anticoagulation) of patients with APE. Therefore CTPA should be considered in all patients with elevated D-dimer or clinical worsening