ArticleInternal medicine journal2021
Acute pulmonary embolism in patients presenting pulmonary deterioration after hospitalisation for non-critical COVID-19.
Article in Internal medicine journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- COVID-19 patients with acute pulmonary embolism have a higher mortality risk: systematic review and meta-analysis based on Italian cohorts.Journal of cardiovascular medicine (Hagerstown, Md.) · 2022Pooled it
- Predictive scores for the diagnosis of Pulmonary Embolism in COVID-19: A systematic review.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Pooled it
- A Comparative Analysis of the Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on the Performance of Clinical Decision-Making Algorithms for Pulmonary Embolism.Journal of clinical medicine · 2024Article
- Clinical Characteristics of SARS-CoV-2 Acute Pulmonary Embolism and Adjusted D-dimer for Emergency Department Patients.The western journal of emergency medicine · 2023Article
- Clinical prediction model for pulmonary thrombosis diagnosis in hospitalized patients with SARS-CoV-2 infection.Journal of clinical and translational research · 2023Article
- [Utility of probability scores for the diagnosis of pulmonary embolism in patients with SARS-CoV-2 infection: A systematic review].Revista clinica espanola · 2023Review
- Revision of Clinical Pre-Test Probability Scores in Hospitalized Patients with Pulmonary Embolism and SARS-CoV-2 Infection.Reviews in cardiovascular medicine · 2023Article
- Diagnostic Management of Acute Pulmonary Embolism in COVID-19 and Other Special Patient Populations.Diagnostics (Basel, Switzerland) · 2022Review
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
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Abstract
backgroundEmerging evidence suggests an association between COVID-19 and acute pulmonary embolism (APE).
aimsTo assess the prevalence of APE in patients hospitalised for non-critical COVID-19 who presented clinical deterioration, and to investigate the association of clinical and biochemical variables with a confirmed diagnosis of APE in these subjects.
methodsAll consecutive patients admitted to the internal medicine department of a general hospital with a diagnosis of non-critical COVID-19, who performed a computer tomography pulmonary angiography (CTPA) for respiratory deterioration in April 2020, were included in this retrospective cohort study.
resultsStudy populations: 41 subjects, median (interquartile range) age: 71.7 (63-76) years, CPTA confirmed APE = 8 (19.51%, 95% confidence interval (CI): 8.82-34.87%). Among patients with and without APE, no significant differences were found with regards symptoms, comorbidities, treatment, Wells score and outcomes. The optimal cut-off value of d-dimer for predicting APE was 2454 ng/mL, sensitivity (95% CI): 63 (24-91), specificity: 73 (54-87), positive predictive value: 36 (13-65), negative predictive value: 89 (71-98) and AUC: 0.62 (0.38-0.85). The standard and age-adjusted d-dimer cut-offs, and the Wells score ≥2 did not associate with confirmed APE, albeit a cut-off value of d-dimer = 2454 ng/mL showed an relative risk: 3.21; 95% CI: 0.92-13.97; P = 0.073. Heparin at anticoagulant doses was used in 70.73% of patients before performing CTPA.
conclusionAmong patients presenting pulmonary deterioration after hospitalisation for non-critical COVID-19, the prevalence of APE is high. Traditional diagnostic tools to identify high APE pre-test probability patients do not seem to be clinically useful. These results support the use of a high index of suspicion for performing CTPA to exclude or confirm APE as the most appropriate diagnostic approach in this clinical setting.
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