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. 2021 Sep;75(9):e14370.
doi: 10.1111/ijcp.14370. Epub 2021 May 29.

Clinical-radiological correlations in COVID-19-related venous thromboembolism: Preliminary results from a multidisciplinary study

Maddalena Alessandra Wu  1 , Riccardo Colombo  2 , Massimo Arquati  3 , Sonia Ippolito  4 , Alba Taino  1 , Diego Ruggiero  5 , Francesca Tonelli  1 , Lucia Trombetta  1 , Pietro Facchinetti  1 , Pierluigi Glielmo  6 , Chiara Cogliati  1 , Nicola Flor  4
Affiliations

Clinical-radiological correlations in COVID-19-related venous thromboembolism: Preliminary results from a multidisciplinary study

Maddalena Alessandra Wu et al. Int J Clin Pract. 2021 Sep.

Abstract

Introduction: Among the multiple complex pathophysiological mechanisms underlying COVID-19 pneumonia, immunothrombosis has been shown to play a key role. One of the most dangerous consequences of the prothrombotic imbalance is the increased incidence of micro- and macrothrombotic phenomena, especially deep vein thrombosis (DVT) and pulmonary embolism (PE).

Methods: We investigated the correlation between radiological and clinical-biochemical characteristics in a cohort of hospitalised COVID-19 patients.

Results: PE was confirmed in 14/61 (23%) patients, five (35.7%) had DVT. The radiographic findings, quantified by Qanadli score calculated on CT angiography, correlated with the clinical score and biochemical markers. The ratio between the right and left ventricle diameter measured at CT angiography correlated with the length of hospital stay.

Conclusion: In our cohort radiological parameters showed a significant correlation with clinical prognostic indices and scores, thus suggesting that a multidisciplinary approach is advisable in the evaluation of PE in COVID-19 patients.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Pulmonary CT angiography of a 59‐year‐old male. The CT scan was obtained 37 days after the onset of COVID‐19 symptoms and on the day the patient was admitted to ED. Axial CT images (A‐B, mediastinum windows) show right segmental pulmonary embolism (thin arrows). Axial and coronal CT images (C‐D, lung windows) show bilateral ground‐glass opacities (arrows) with typical posterior peripheral distribution
FIGURE 2
FIGURE 2
Correlation between radiological score of thromboembolic burden (Qanadli score) and clinicalbiochemical markers. Correlation of Qanadli score with PESI (r = 0.774, 95%CI 0.372 to 0.931, P = 0.003), D‐dimer (r = 0.679, 95%CI 0.188 to 0.899, P = .013), high‐sensitivity troponin (r = 0.683, 95%CI 0.161 to 0.906, P = 0.017), serum albumin (r = −0.592, 95%CI −0.867 to −0.043, P = 0.036), arterial pressure of oxygen to inspired fraction of oxygen ratio (pO2/FiO2) (r = −0.687, 96%CI −0.902 to −0.202, P = 0.011), and length of hospital stay (r = 0.585, 95%CI 0.032 to 0.864, P =.038). hs‐Troponin, high sensitivity troponin; LOS‐H, length of hospital stay
See this image and copyright information in PMC

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