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Multicenter Study
. 2021 Aug;107(2):190-201.
doi: 10.1111/ejh.13638. Epub 2021 May 24.

White blood count, D-dimers, and ferritin levels as predictive factors of pulmonary embolism suspected upon admission in noncritically ill COVID-19 patients: The French multicenter CLOTVID retrospective study

Joris Galland  1   2 , Benjamin Thoreau  2   3   4 , Maxime Delrue  5   6 , Marie Neuwirth  5   7 , Alain Stepanian  5   6 , Anthony Chauvin  2   8 , Azeddine Dellal  9 , Olivier Nallet  10 , Melanie Roriz  11 , Mathilde Devaux  12 , Jonathan London  13 , Gonzague Martin-Lecamp  14 , Antoine Froissart  15 , Nouara Arab  15 , Bertrand Ferron  16 , Marie-Helene Groff  17 , Viviane Queyrel  18 , Christine Lorut  19 , Lucile Regard  19 , Emilie Berthoux  20 , Guillaume Bayer  21 , Chloe Comarmond  22   23 , Bertrand Lioger  24 , Arsène Mekinian  23   25 , Tali-Anne Szwebel  3 , Thomas Sené  26 , Blanca Amador-Boreiro  1   2 , Olivier Mangin  1   2 , Pierre-Olivier Sellier  27 , Stephane Mouly  1   2 , Jean-Philippe Kevorkian  28 , Virginie Siguret  2   5   7 ; Lariboisière COVID Group; Dominique Vodovar  2   29   30 , Damien Sene  1   2
Collaborators, Affiliations
Multicenter Study

White blood count, D-dimers, and ferritin levels as predictive factors of pulmonary embolism suspected upon admission in noncritically ill COVID-19 patients: The French multicenter CLOTVID retrospective study

Joris Galland et al. Eur J Haematol. 2021 Aug.

Abstract

Background: A high prevalence of pulmonary embolism (PE) has been described during COVID-19. Our aim was to identify predictive factors of PE in non-ICU hospitalized COVID-19 patients.

Methods: Data and outcomes were collected upon admission during a French multicenter retrospective study, including patients hospitalized for COVID-19, with a CT pulmonary angiography (CTPA) performed in the emergency department for suspected PE. Predictive factors significantly associated with PE were identified through a multivariate regression model.

Results: A total of 88 patients (median [IQR] age of 68 years [60-78]) were analyzed. Based on CTPA, 47 (53.4%) patients were diagnosed with PE, and 41 were not. D-dimer ≥3000 ng/mL (OR 8.2 [95% CI] 1.3-74.2, sensitivity (Se) 0.84, specificity (Sp) 0.78, P = .03), white blood count (WBC) ≥12.0 G/L (29.5 [2.3-1221.2], Se 0.47, Sp 0.92, P = .02), and ferritin ≥480 µg/L (17.0 [1.7-553.3], Se 0.96, Sp 0.44, P = .03) were independently associated with the PE diagnosis. The presence of the double criterion D-dimer ≥3000 ng/mL and WBC ≥12.0 G/L was greatly associated with PE (OR 21.4 [4.0-397.9], P = .004).

Conclusion: The white blood count, the D-dimer and ferritin levels could be used as an indication for CTPA to confirm PE on admission in non-ICU COVID-19 patients.

Keywords: COVID‐19; D‐dimer; SARS‐CoV‐2; ferritin; predictive factor; pulmonary embolism; white blood count.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Flowchart of the CLOTVID study. ICU, Intensive care unit; PE, pulmonary embolism; NON‐PE, absence of PE; RT‐PCR, reverse transcriptase‐polymerase chain reaction
FIGURE 2
FIGURE 2
Biomarker levels according to pulmonary embolism status. Comparison of biomarkers according to PE status for D‐dimer level (Panel A), White Blood Count (Panel B), Ferritin (Panel C), and Prothrombin Time ratio (Panel D)
FIGURE 3
FIGURE 3
Receiver operating characteristic for biomarkers. ROC curves for D‐dimer level (Panel A), White Blood Count (Panel B), Ferritin (Panel C), and Prothrombin Time ratio (Panel D)
See this image and copyright information in PMC

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