Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2020 Dec:196:486-490.
doi: 10.1016/j.thromres.2020.10.012. Epub 2020 Oct 15.

The prevalence of pulmonary embolism in patients with COVID-19 and respiratory decline: A three-setting comparison

Renée A G Brüggemann  1 , Bart Spaetgens  2 , Hester A Gietema  3 , Steffie H A Brouns  2 , Patricia M Stassen  2 , Fabienne J Magdelijns  2 , Roger J Rennenberg  2 , Ronald M A Henry  2 , Mark M G Mulder  4 , Bas C T van Bussel  5 , Ronny M Schnabel  4 , Iwan C C van der Horst  6 , Joachim E Wildberger  7 , Coen D A Stehouwer  8 , Hugo Ten Cate  9
Affiliations
Comparative Study

The prevalence of pulmonary embolism in patients with COVID-19 and respiratory decline: A three-setting comparison

Renée A G Brüggemann et al. Thromb Res. 2020 Dec.

Abstract

Background: The risk of pulmonary embolism (PE) in patients with Coronavirus Disease 2019 (COVID-19) is recognized. The prevalence of PE in patients with respiratory deterioration at the Emergency Department (ED), the regular ward, and the Intensive Care Unit (ICU) are not well-established.

Objectives: We aimed to investigate how often PE was present in individuals with COVID-19 and respiratory deterioration in different settings, and whether or not disease severity as measured by CT-severity score (CTSS) was related to the occurrence of PE.

Patients/methods: Between April 6th and May 3rd, we enrolled 60 consecutive adult patients with confirmed COVID-19 from the ED, regular ward and ICU who met the pre-specified criteria for respiratory deterioration.

Results: A total of 24 (24/60: 40% (95% CI: 28-54%)) patients were diagnosed with PE, of whom 6 were in the ED (6/23: 26% (95% CI: 10-46%)), 8 in the regular ward (8/24: 33% (95% CI: 16-55%)), and 10 in the ICU (10/13: 77% (95% CI: 46-95%)). CTSS (per unit) was not associated with the occurrence of PE (age and sex-adjusted OR 1.06 (95%CI 0.98-1.15)).

Conclusion: The number of PE diagnosis among patients with COVID-19 and respiratory deterioration was high; 26% in the ED, 33% in the regular ward and 77% in the ICU respectively. In our cohort CTSS was not associated with the occurrence of PE. Based on the high number of patients diagnosed with PE among those scanned we recommend a low threshold for performing computed tomography angiography in patients with COVID-19 and respiratory deterioration.

Keywords: COVID-19 (coronavirus disease 2019); Computed tomography angiography; Pulmonary embolism; Thromboprophylaxis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no relevant conflicts of interest for the submitted work.

Figures

Fig. 1
Fig. 1
Criteria for respiratory deterioration per setting.
Fig. 2
Fig. 2
Development of pulmonary embolism subdivided by setting.
See this image and copyright information in PMC

References

    1. University JH Coronavirus Resource Center. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) https://coronavirus.jhu.edu.map.html Available at:
    1. ACR recommendations for the use of Chest Radiography and Computed Tomography (CT) for suspected COVID-19 infection. https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recom... Available at:
    1. Lippi G., Favaloro E.J. D-dimer is associated with severity of coronavirus disease 2019: a pooled analysis. Thromb. Haemost. 2020;120(5):876–878. - PMC - PubMed
    1. van Maanen R., Rutten F.H., Klok F.A. Validation and impact of a simplified clinical decision rule for diagnosing pulmonary embolism in primary care: design of the PECAN prospective diagnostic cohort management study. BMJ Open. 2019;9(10) - PMC - PubMed
    1. Wolf S.J., McCubbin T.R., Feldhaus K.M. Prospective validation of Wells criteria in the evaluation of patients with suspected pulmonary embolism. Ann. Emerg. Med. 2004;44(5):503–510. - PubMed

Publication types

MeSH terms