Acute pulmonary embolism in non-hospitalized COVID-19 patients referred to CTPA by emergency department

Autor: Carole Helissey, Evelyne Peroux, Caroline Bouzad, Alban Gervaise
Rok vydání: 2020
Předmět:
Male
Computed Tomography Angiography
Pleural effusion
Comorbidity
030218 nuclear medicine & medical imaging
0302 clinical medicine
Outpatients
Referral and Consultation
Neuroradiology
Aged
80 and over
medicine.diagnostic_test
Age Factors
Interventional radiology
General Medicine
Middle Aged
Pulmonary embolism
Causality
medicine.anatomical_structure
CT angiography
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
Acute Disease
Chest
Female
Radiology
Coronavirus Infections
Emergency Service
Hospital
Adult
medicine.medical_specialty
Pneumonia
Viral
Pulmonary Artery
Betacoronavirus
Young Adult
03 medical and health sciences
medicine
Humans
Radiology
Nuclear Medicine and imaging
Pandemics
Aged
Retrospective Studies
Lung
SARS-CoV-2
business.industry
COVID-19
Retrospective cohort study
Pneumonia
Emergency department
medicine.disease
Coronavirus
business
Zdroj: European Radiology
ISSN: 1432-1084
0938-7994
Popis: To evaluate the prevalence of acute pulmonary embolism (APE) in non-hospitalized COVID-19 patients referred to CT pulmonary angiography (CTPA) by the emergency department. From March 14 to April 6, 2020, 72 non-hospitalized patients referred by the emergency department to CTPA for COVID-19 pneumonia were retrospectively identified. Relevant clinical and laboratory data and CT scan findings were collected for each patient. CTPA scans were reviewed by two radiologists to determinate the presence or absence of APE. Clinical classification, lung involvement of COVID-19 pneumonia, and CT total severity score were compared between APE group and non-APE group. APE was identified in 13 (18%) CTPA scans. The mean age and D-dimer of patients from the APE group were higher in comparison with those from the non-APE group (74.4 vs. 59.6 years, p = 0.008, and 7.29 vs. 3.29 μg/ml, p = 0.011). There was no significant difference between APE and non-APE groups concerning clinical type, COVID-19 pneumonia lung lesions (ground-glass opacity: 85% vs. 97%; consolidation: 69% vs. 68%; crazy paving: 38% vs. 37%; linear reticulation: 69% vs. 78%), CT severity score (6.3 vs. 7.1, p = 0.365), quality of CTPA (1.8 vs. 2.0, p = 0.518), and pleural effusion (38% vs. 19%, p = 0.146). Non-hospitalized patients with COVID-19 pneumonia referred to CT scan by the emergency departments are at risk of APE. The presence of APE was not limited to severe or critical clinical type of COVID-19 pneumonia. • Acute pulmonary embolism was found in 18% of non-hospitalized COVID-19 patients referred by the emergency department to CTPA. Two (15%) patients had main, four (30%) lobar, and seven (55%) segmental acute pulmonary embolism. • Five of 13 (38%) patients with acute pulmonary embolism had a moderate clinical type. • Severity and radiological features of COVID-19 pneumonia showed no significant difference between patients with or without acute pulmonary embolism.
Databáze: OpenAIRE
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