Document Type : Original Article
Authors
1 Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
2 Assisstant professor of Radiology, Shahid Beheshti University of Medical Sciences, Shohadaye Tajrish Hospital, Tehran, Iran
3 Student. Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
COVID-19, caused by SARS-CoV-2, has been associated with a high prevalence of thromboembolic complications, particularly pulmonary thromboembolism (PTE). This study aims to investigate the incidence of pulmonary thromboembolism (PTE) in hospitalized COVID-19 patients and its correlation with clinical and demographic factors, enhancing understanding of the associated risks and outcomes.
Materials and Methods: A cross-sectional descriptive study was conducted at Shohadaye Tajrish Hospital in Tehran, Iran, in 2023. 100 hospitalized COVID-19 patients with suspected PTE underwent CT pulmonary angiography. Data on demographics, comorbidities, severity of COVID-19, and PTE outcomes were collected and analyzed. Statistical comparisons were made between PTE and non-PTE groups to identify potential risk factors.
Results: PTE was diagnosed in 24% of COVID-19 patients, with a mean age of 58.79 years (SD = 11.56). The prevalence of PTE was higher in females (63%). No significant differences were found between the PTE and non-PTE groups in age, gender, or severity of lung involvement. Severe PTE occurred in 45.8% of cases, with an overall PTE-related mortality rate of 20.1%. Elevated D-dimer levels were identified as a predictive marker for PTE; however, no significant differences in clinical severity or mortality were found based on PTE status.
Conclusion: Hospitalized COVID-19 patients are at significant risk for PTE, which may occur independently of baseline demographics or COVID-19 severity. Our findings highlight the importance of monitoring thromboembolic complications and timely interventions, particularly in patients with elevated D-dimer levels.
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- Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3.doi: 1038/s41586-020-2012-7
- Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33.doi: 1056/NEJMoa2001017
- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.doi: 1016/S0140-6736(20)30211-7
- Available from: Available from: Control CfD, Prevention. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). 2020.
- Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-47.doi: 1002/ajh.25829
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.doi: 1016/S0140-6736(20)30183-5
- Yin S, Huang M, Li D, Tang N. Difference of coagulation features between severe pneumonia induced by SARS-CoV2 and non-SARS-CoV2. J Thromb Thrombolysis. 2021;51(4):1107-10.doi: 1007/s11239-020-02105-8
- Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected with Pulmonary CT Angiography. Radiology. 2020;296(3):E186-e8. doi: 1148/radiol.2020201544
- Majidzadeh AK, Khalaj V, Fatemeh D, Mahdi H, Farzaneh B, Ahmad A, et al. Cloning and expression of functional full-length human tissue plasminogen activator in Pichia pastoris. Appl Biochem Biotechnol. 2010;162(7):2037-48.doi: 1007/s12010-010-8979-z
- Miró Ò, Jiménez S, Mebazaa A, Freund Y, Burillo-Putze G, Martín A, et al. Pulmonary embolism in patients with COVID-19: incidence, risk factors, clinical characteristics, and outcome. Eur Heart J. 2021;42(33):3127-42.doi: 1093/eurheartj/ehab314
- Riyahi S, Dev H, Behzadi A, Kim J, Attari H, Raza SI, et al. Pulmonary Embolism in Hospitalized Patients with COVID-19: A Multicenter Study. Radiology. 2021;301(3):E426-e33.doi: 1148/radiol.2021210777
- Ng JJ, Liang ZC, Choong A. The incidence of pulmonary thromboembolism in COVID-19 patients admitted to the intensive care unit: a meta-analysis and meta-regression of observational studies. J Intensive Care. 2021;9(1):20.doi: 1186/s40560-021-00535-x
- Léonard-Lorant I, Delabranche X, Séverac F, Helms J, Pauzet C, Collange O, et al. Acute Pulmonary Embolism in Patients with COVID-19 at CT Angiography and Relationship to d-Dimer Levels. Radiology. 2020;296(3):E189-e91.doi: 1148/radiol.2020201561
- van Belle A, Büller HR, Huisman MV, Huisman PM, Kaasjager K, Kamphuisen PW, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. Jama. 2006;295(2):172-9.doi: 1001/jama.295.2.172
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