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Published on: December 19, 2020
Changing face of pulmonary embolism with COVID-19
Bayram Bagırtan1, Emine Altuntas1, Servan Yasar2
1Cardiology Department , Sancaktepe Sehit Prof Dr Ilhan Varank Education and Training Hospital, Istanbul, Turkey.
Insights
This study found that traditional clinical scores have limited use in diagnosing pulmonary embolism in COVID-19 patients. A higher D-dimer threshold is recommended for accurate pulmonary embolism diagnosis in these patients.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Critical Care
Background:
- Pulmonary embolism (PE) is a serious complication of coronavirus disease 2019 (COVID-19).
- Accurate risk stratification and diagnosis of PE in COVID-19 patients remain challenging.
Purpose of the Study:
- To characterize baseline features of COVID-19 patients with PE.
- To evaluate the utility of clinical predictive scores (Geneva score, PESI) and biochemical markers (D-dimer) in this population.
Main Methods:
- Retrospective analysis of 41 COVID-19 patients diagnosed with PE between March 2020 and June 2021.
- Assessment of D-dimer levels, Geneva score, Pulmonary Embolism Severity Index (PESI), and Qanadli score.
Main Results:
- Mean D-dimer level was 6.04 mg/dl; 61% received anticoagulation.
- An optimal D-dimer cut-off of 5.69 mg/dl was identified for patients on deep venous thrombosis prophylaxis (AUC 0.753).
- Mean scores: Geneva 4.31, PESI 72.48, Qanadli 11.29.
Conclusions:
- Traditional clinical predictive scores demonstrated limited discriminatory power in COVID-19 patients with PE.
- A higher D-dimer cut-off value may be necessary for improved PE diagnosis in this cohort.
Aim:
This study aimed to describe the baseline characteristics of coronavirus disease 2019 (COVID-19) patients with pulmonary embolism, and to examine the Geneva score, pulmonary embolism severity index (PESI), radiological and biochemical findings.
Methods:
From March 2020 to June 2021, the files of 41 COVID-19 patients with pulmonary embolism were accessed.
Results:
Mean D-dimer value was 6.04 mg/dl and 61% of the patients received at least one dose of anticoagulant treatment. In patients receiving deep venous thrombosis prophlaxis, an optimal D-dimer cut-off point was calculated as 5.69 mg/dl. The area under the curve was 0.753 (p = 0.007; sensivity 64%; specificity 62.5%). The mean Geneva score was 4.31, mean PESI was 72.48 and mean Qanadli score was 11.29.
Conclusions:
According to this study, traditional clinical predictive scores had little discriminatory power in these patients, and a higher D-dimer cut-off value should be considered to better diagnose patients for pulmonary embolism.
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