COVID-19: 1 in 20 prevalence of pulmonary embolism found in French hospitals

  • Planquette B & al.
  • Thromb Res
  • 7 Nov 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Among patients hospitalized with COVID-19, the pulmonary embolism (PE) prevalence is 1 in 20.
  • In cases of CT for clinical suspicion for PE, PE prevalence is about 1 in 5.

Why this matters

  • PE is common with COVID-19 pneumonia.
  • ICU patients with COVID-19 have especially high PE risk.
  • PE and extension of COVID-19 lesions correlate on CT.

Key results

  • 1042 patients with COVID-19.
  • 25.8% had CT pulmonary angiography.
  • PE prevalence:
    • 5.6% overall.
    • 21.2% among those having CT.
  • Need for invasive mechanical ventilation was linked to increased PE risk:
    • OR: 2.79 (95% CI, 1.33-5.84).
  • Mortality:
    • 20.3% with PE vs 16.1% without PE on CT. 
    • OR: 1.36 (95% CI, 0.53-3.14).
  • PE was linked to more extensive COVID-19 lesions on CT vs no PE on CT:
    • OR: 3.9 (95% CI, 1.54-9.94).
    • Also linked to parenchymal lesions >50%.
  • Patients with PE had greater odds of having elevated C-reactive protein:
    • OR: 3.36 (95% CI, 1.58-7.14).
  • PE risk was 5.11-fold higher with D-dimer >2605 ng/mL (95% CI, 1.90-13.76).

Study design

  • Retrospective, multicentric case-control series evaluating PE prevalence, characteristics in consecutive French patients hospitalized with COVID-19 pneumonia; 2 French hospitals.
  • Funding: None disclosed.

Limitations

  • Retrospective.
  • Immortal time bias.
  • Inconsistent CT investigations.