Pulmonary Embolism in COVID-19 Patients: A Retrospective Case-Control Study.

Autor:	Alaithan FA; Radiology, Dammam Medical Complex, Dammam, SAU., Aljawad MH; Radiology, King Fahd University Hospital, Al-Khobar, SAU., Ghawas AH; General Practice, Dhurma General Hospital, Dhurma, SAU., Althobaiti AS; General Practice, Al Faisaliah Primary Health Care Center, Dammam, SAU., Almuslem QA; General Practice, Al Naeriyah Hospital, Dammam, SAU., Bin Nasif MH; College of Medicine, King Saud University, Riyadh, SAU., Algharbi FF; College of Medicine, King Khalid University Hospital, Riyadh, SAU., Alshehri RA; College of Medicine, King Abdulaziz University, Jeddah, SAU., Al Gethami YK; College of Medicine, Taif University, Al-Taif, SAU., Altowayan KW; College of Medicine, King Saud University, Riyadh, SAU., Alzahrani FK; College of Medicine, King Saud University, Riyadh, SAU., Suwaylih AA; College of Medicine, Hadhramout University, Al-Mukalla, YEM., Alwadai AS; College of Medicine, King Khalid University, Abha, SAU., Badawi AM; College of Medicine, King Abdulaziz University, Jeddah, SAU., Alshammari M; College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2021 Oct 19; Vol. 13 (10), pp. e18887. Date of Electronic Publication: 2021 Oct 19 (Print Publication: 2021).
DOI:	10.7759/cureus.18887
Abstrakt:	Background: Coagulopathy is a well-recognized complication in patients with coronavirus disease 2019 (COVID-19). Pulmonary embolism (PE) has substantial morbidity and mortality if the diagnosis is missed or the management is delayed. Computed tomography pulmonary angiography (CT-PA) is the imaging modality of choice for PE. Therefore, this study aimed to investigate the positive rate of CT-PA for PE among patients with COVID-19. Methods: We conducted a retrospective study examining the diagnostic yield of CT-PA in patients with confirmed COVID-19 and compared it with that in patients without COVID-19. The study included all adult patients with confirmed COVID-19 who presented from June 2020 to June 2021. Results: The study included 316 patients, including 158 patients with COVID-19, who underwent CT-PA for ruling out PE. Overall, 76 patients were found to have PE on the CT-PA scan, yielding a positive rate of 24.1%, with a significant difference between patients with COVID-19 (8.2%) and those without COVID-19 (39.9%). Further, 138 (87.3%) patients with COVID-19 had elevated D-dimer levels compared with 34 (21.5%) patients without COVID-19. A multivariable regression analysis model revealed that the smoking status (odds ratio [OR] = 1.94; 95% confidence interval [CI]: 1.4-3.8) and obesity (OR = 4.1; 95% CI: 1.5-8.9) were independent predictors of PE among patients with COVID-19. However, the elevated D-dimer level was not significantly associated with PE among patients with COVID-19 (OR = 0.7; 95% CI: 0.4-1.8). Conclusion: The study found that the positive rate of CT-PA for PE was lower among patients with PE indicating probable overutilization of investigation in these patients. Additionally, patients with COVID-19 had a higher proportion of elevated D-dimer levels that may be a contributor to the increased investigation for PE. Lastly, patients with COVID-19 who were current smokers had a higher tendency of having PE. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2021, Alaithan et al.)
Databáze:	MEDLINE
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