High incidence of pulmonary thromboembolism in hospitalized SARS-CoV-2 infected patients despite thrombo-prophylaxis

Heart Lung. 2022 May-Jun:53:77-82. doi: 10.1016/j.hrtlng.2022.02.003. Epub 2022 Feb 8.

Abstract

Background: SARS-CoV-2 infected patients present thrombotic complications caused by direct endothelial cells injury of the microvessels. Pulmonary thromboembolism (PE) has been reported by Computed Tomography pulmonary angiogram (CTPA) in patients with COVID-19 pneumonia with high D-dimer levels.

Objectives: We present the characteristics of SARS-CoV-2 infected patients diagnosed of PE by CTPA in our hospital. We also present the comparison of these findings with non-infected patients with PE data.

Methods: Retrospective observational cohort study that included patients over 18 years of age hospitalised consecutively between 26th February and 20th May 2020 in an European Hospital with SARS-CoV2 virus infection, and with suspected infection at beginning of admission but with negative PCR, who were studied with CTPA for suspicion of VTE, during their hospitalization.

Results: During the study period, 52 CTPA were performed in our hospital, sixteen in SARS-CoV-2 infected patients, with 4 cases (33%) of PE in the infected group, and 11 (44%) in the non-infected group. No significant differences in age (p = 0.43) and sex (p = 0.31) were found between the two groups, infected and non-infected patients. In the infected group, the patients who had PE had a much lower median age (47.8 years) than those without PE (73.3 years). No differences between infected and non-infected patients were detected in the diagnosis of PE with CTPA, 28.6% versus 27.8% (p = 1.00). Overall patient mortality was 1.9%; one patient died (6.3%) in the infected group, and none in the non-infected group (p = 0.31).

Conclusion: A considerable incidence of PE diagnosed by CTPA in SARS-CoV-2 infected patients has been observed, despite thrombo-prophylaxis.

Keywords: COVID-19; Coagulation; Coronavirus; SARS-CoV-2; Thromboembolism; Thrombosis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • COVID-19* / complications
  • Endothelial Cells
  • Fibrin Fibrinogen Degradation Products
  • Humans
  • Incidence
  • Middle Aged
  • Pulmonary Embolism* / diagnosis
  • Pulmonary Embolism* / virology
  • RNA, Viral
  • Retrospective Studies
  • SARS-CoV-2

Substances

  • Fibrin Fibrinogen Degradation Products
  • RNA, Viral