Pulmonary artery thrombi are co-located with opacifications in SARS-CoV2 induced ARDS

Autor: Katharina Mueller-Peltzer, Tobias Krauss, Dawid L. Staudacher, Corinna N. Lang, Fabian Bamberg, Christoph Bode, Matthias Benndorf, Viviane Zotzmann, Daniel Duerschmied
Rok vydání: 2020
Předmět:
Pulmonary and Respiratory Medicine
ECMO
veno-venous extracorporeal membrane oxygenation
medicine.medical_specialty
ARDS
COVID19
BMI
body mass index
ROI
region of interest
PAT
pulmonary artery thrombi
Clinical Trial Paper
CTPA
computed tomography pulmonary angiogram
03 medical and health sciences
0302 clinical medicine
medicine.artery
medicine
Pulmonary angiography
HU
houndsfield units
CTPA
030212 general & internal medicine
CT-Scan
TISS
therapeutic intervention scoring system
Computed tomography angiography
Lung
medicine.diagnostic_test
business.industry
Pulmonary embolism
Pulmonary artery thrombosis
SAPS2
simplified acute physiology score 2
GGO
ground-glass opacification
PAPsys
systolic pulmonary arterial pressure
medicine.disease
ICU
intensive care unit
Thrombosis
Pneumonia
medicine.anatomical_structure
030228 respiratory system
SARS-CoV2
Pulmonary artery
Radiology
SD
standard deviation
business
Zdroj: Respiratory Medicine
ISSN: 0954-6111
DOI: 10.1016/j.rmed.2020.106135
Popis: Purpose Patients hospitalized for infection with SARS-CoV-2 typically present with pneumonia. The respiratory failure is frequently complicated by pulmonary embolism in segmental pulmonary arteries. The distribution of pulmonary embolism in regard to lung parenchymal opacifications has not been investigated yet. Methods All patients with COVID-19 treated at a medical intensive care unit between March 8th and April 15th, 2020 undergoing computed tomography pulmonary angiography (CTPA) were included. All CTPA were assessed by two radiologists independently in respect to parenchymal changes and pulmonary embolism on a lung segment basis. Results Out of 22 patients with severe COVID-19 treated within the observed time period, 16 (age 60.4 ± 10.2 years, 6 female SAPS2 score 49.2 ± 13.9) underwent CT. A total of 288 lung segment were analyzed. Thrombi were detectable in 9/16 (56.3%) patients, with 4.4 ± 2.9 segments occluded per patient and 40/288 (13.9%) segments affected in the whole cohort. Patients with thrombi had significantly worse segmental opacifications in CT (p
Highlights (mandatory) • In COVID-19 respiratory failure, thrombi in segmental pulmonary arteries are common. • All Thrombi detected were localized in opacitated (presumably COVID-19 affected) lung segments. • This might suggest local clot formation.
Databáze: OpenAIRE
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