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. 2022 Aug;29(4):625-629.
doi: 10.1007/s10140-022-02039-z. Epub 2022 Apr 21.

Incidence of pulmonary embolism in COVID-19 infection in the ED: ancestral, Delta, Omicron variants and vaccines

Nicole Law  1 , Jessica Chan  1 , Christopher Kelly  2 , William F Auffermann  1 , Dell P Dunn  3
Affiliations

Incidence of pulmonary embolism in COVID-19 infection in the ED: ancestral, Delta, Omicron variants and vaccines

Nicole Law et al. Emerg Radiol. 2022 Aug.

Abstract

Purpose: This retrospective review examines the incidence of pulmonary embolism (PE) during computed tomography pulmonary angiography (CTPA) exams performed in the emergency room setting of a tertiary care center over dominant periods of the ancestral, Delta, and Omicron variants of COVID-19.

Materials/methods: Demographic information, patient comorbidities and risk factors, vaccination status, and COVID-19 infection status were collected from patient's charts. Incidence of PE in COVID positive patients was compared between variant waves. Subgroup analysis of vaccination effect was performed.

Results: CTPA was ordered in 18.3% of COVID-19 positive patients during the ancestral variant period, 18.3% during the Delta period and 17.3% during the Omicron wave. PE was seen in 15.0% of the ancestral COVID-19 variant cohort, 10.6% in the Delta COVID cohort and 9.23% of the Omicron cohort, reflecting a 41% and 60% increased risk of PE with ancestral variants compared to Delta and Omicron periods respectively. The study however was underpowered and the difference in rate of PE did not reach statistically significance (p = 0.43 and p = 0.22). Unvaccinated patients had an 2.75-fold increased risk of COVID-associated PE during the Delta and Omicron periods (p = .02) compared to vaccinated or recovered patients.

Conclusion: Vaccination reduces the risk of COVID-19 associated PE. Patients infected with the Delta and Omicron COVID-19 variants may have a lower incidence of pulmonary embolism, though a larger or multi-institution study is needed to prove definitively.

Keywords: Ancestral; Blood clots; COVID-19; Computed-tomography angiography; Delta; Delta variant; Emergency department; Omicron; Omicron variant; Pulmonary embolism.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
COVID positive case counts in the state of Utah, obtained from https://coronavirus.utah.gov/case-counts/ Accessed 3/1/2022. Superimposed orange bars indicate the time ranges selected for the ancestral cohort (11/15–12/29/2020), Delta variant cohort (8/10–9/23/2021), and Omicron variant cohort (1/1/2022–2/18/2022)
Fig. 2
Fig. 2
Venn diagram depicting the total number of ER visits within the selected time ranges, and of those visits the number involving COVID + patients and/or a CTPA exam
See this image and copyright information in PMC

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Supplementary concepts