Predicting acute pulmonary embolism in COVID-19.

Area of Science:

• Pulmonology
• Infectious Diseases
• Clinical Pathology

Background:

• Acute pulmonary embolism (PE) is a critical concern in COVID-19 patients.
• Computed tomography pulmonary angiography (CTPA) is the gold standard for PE diagnosis but is costly and not universally accessible.

Purpose of the Study:

• To evaluate the utility of cost-effective clinical and laboratory parameters, including C-reactive protein (CRP) lymphocyte ratio (CLR) and ferritin CRP ratio (FCR), for diagnosing PE in COVID-19 patients.
• To identify predictors of PE and mortality in this patient population.

Main Methods:

• Retrospective analysis of 127 COVID-19 patients diagnosed with PE and 105 without PE.
• Recorded clinical data, symptoms, respiratory rate, SpO2, and laboratory parameters (e.g., CRP, ferritin, lymphocytes, eosinophils) at initial admission.

Main Results:

• Patients with PE exhibited lower eosinophil levels and higher ferritin lymphocyte ratio and CLR compared to those without PE.
• Shortness of breath and tiredness were more prevalent in the PE group.
• Elevated ferritin, CRP, and CLR were associated with increased mortality risk.
• Decreased eosinophils and increased CLR, D-dimer, and CRP levels may predict PE.

Conclusions:

• Elevated CLR is a strong predictor of PE in COVID-19 patients and is linked to increased mortality.
• COVID-19 patients with a CLR exceeding 81 warrant further investigation for PE.