Prevalence and characteristics of pulmonary embolism in 1042 COVID-19 patients with respiratory symptoms: A nested case-control study.

Autor: Planquette B; Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Department of Respiratory Medicine, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France. Electronic address: benjamin.planquette@aphp.fr., Le Berre A; Department of Radiology, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France., Khider L; Université de Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS FRE 2031, F-75011 Paris, France; Department of Vascular Medicine, France., Yannoutsos A; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France; INSERM CRESS UMR 1153, F-75005 Paris, France., Gendron N; Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Haematology, France., de Torcy M; Department of Respiratory Medicine, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France., Mohamedi N; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Vascular Medicine, France., Jouveshomme S; Department of Respiratory Medicine, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France., Smadja DM; Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Haematology, France; F-CRIN INNOVTE, Saint-Étienne, France., Lazareth I; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France., Goudot G; Université de Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS FRE 2031, F-75011 Paris, France; Department of Vascular Medicine, France., Fournier L; Université de Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Radiology, France; Paris research cardiovascular center PARCC INSERM UMR-S 970, F-75015 Paris, France., Bruel C; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Intensive Care Unit, France., Diehl JL; Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Intensive Care Unit, France., Mourad JJ; Université de Paris, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Internal Medicine, France., Meyer G; Université de Paris, France; Department of Respiratory Medicine, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France; Paris research cardiovascular center PARCC INSERM UMR-S 970, F-75015 Paris, France; INSERM CIC 14-18, F-75015 Paris, France., Priollet P; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France., Messas E; Université de Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS FRE 2031, F-75011 Paris, France; Department of Vascular Medicine, France; Paris research cardiovascular center PARCC INSERM UMR-S 970, F-75015 Paris, France., Sanchez O; Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Department of Respiratory Medicine, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France., Beaussier H; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Clinical Investigation, France., Mirault T; Université de Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Vascular Medicine, France; Paris research cardiovascular center PARCC INSERM UMR-S 970, F-75015 Paris, France., Zins M; Department of Radiology, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France., Chatelier G; Université de Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; INSERM CIC 14-18, F-75015 Paris, France; Department of statistics, bioinformatics and public health, France., Emmerich J; Université de Paris, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France; INSERM CRESS UMR 1153, F-75005 Paris, France.
Jazyk: angličtina
Zdroj: Thrombosis research [Thromb Res] 2021 Jan; Vol. 197, pp. 94-99. Date of Electronic Publication: 2020 Nov 07.
DOI: 10.1016/j.thromres.2020.11.001
Abstrakt: Introduction: Coronavirus disease 2019 (COVID-19) has been associated with cardiovascular complications and coagulation disorders. Previous studies reported pulmonary embolism (PE) in severe COVID-19 patients. Aim of the study was to estimate the prevalence of symptomatic PE in COVID-19 patients and to identify the clinical, radiological or biological characteristics associated with PE.
Patients/methods: We conducted a retrospective nested case-control study in 2 French hospitals. Controls were matched in a 1:2 ratio on the basis of age, sex and center. PE patients with COVID-19 were compared to patients in whom PE was ruled out (CTPA controls) and in whom PE has not been investigated (CT controls).
Results: PE was suspected in 269 patients among 1042 COVID-19 patients, and confirmed in 59 patients (5.6%). Half of PE was diagnosed at COVID-19 diagnosis. PE patients did not differ from CT and CTPA controls for thrombosis risk factors. PE patients more often required invasive ventilation compared to CTPA controls (odds ratio (OR) 2.79; 95% confidence interval (CI) 1.33-5.84) and to CT controls (OR 8.07; 95% CI 2.70-23.82). PE patients exhibited more extensive parenchymal lesions (>50%) than CT controls (OR 3.90; 95% CI 1.54-9.94). D-dimer levels were 5.1 (95% CI 1.90-13.76) times higher in PE patients than CTPA controls.
Conclusions: Our results suggest a PE prevalence in COVID-19 patients close to 5% in the whole population and to 20% of the clinically suspected population. PE seems to be associated with more extensive lung damage and to require more frequently invasive ventilation.
(Copyright © 2020. Published by Elsevier Ltd.)
Databáze: MEDLINE
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