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Multicenter Study
. 2024;61(3):142-150.
doi: 10.1159/000538312. Epub 2024 Apr 17.

The Incidence of Pulmonary Embolism in Hospitalized Non-ICU Patients with COVID-19 during the First Wave: A Multicenter Retrospective Cohort Study in the Netherlands

Arno F G Maas  1 , Caroline Wyers  1 , Arne Dielis  1 , Dennis G Barten  2 , Vivian E M van Kampen  3 , Thomas E van der Krieken  4 , Martijn de Kruif  5 , Suat Simsek  6   7 , Bart Spaetgens  8 , Thijs van Haaps  9 , Brent Appelman  10 , Niels C Gritters  11 , Stefan Doornbos  11 , Hazra S Moeniralam  12 , Peter G Noordzij  13 , Auke Reidinga  14 , Renée A Douma  15 , Esther J Nossent  16 , Martijn Beudel  17 , Paul Elbers  18 , Saskia Middeldorp  8 , Nick van Es  8 , Joop P W van den Bergh  1   19 , Frits H M van Osch  19   20
Affiliations
Multicenter Study

The Incidence of Pulmonary Embolism in Hospitalized Non-ICU Patients with COVID-19 during the First Wave: A Multicenter Retrospective Cohort Study in the Netherlands

Arno F G Maas et al. J Vasc Res. 2024.

Abstract

Introduction: During the first COVID-19 outbreak in 2020 in the Netherlands, the incidence of pulmonary embolism (PE) appeared to be high in COVID-19 patients admitted to the intensive care unit (ICU). This study was performed to evaluate the incidence of PE during hospital stay in COVID-19 patients not admitted to the ICU.

Methods: Data were retrospectively collected from 8 hospitals in the Netherlands. Patients admitted between February 27, 2020, and July 31, 2020, were included. Data extracted comprised clinical characteristics, medication use, first onset of COVID-19-related symptoms, admission date due to COVID-19, and date of PE diagnosis. Only polymerase chain reaction (PCR)-positive patients were included. All PEs were diagnosed with computed tomography pulmonary angiography (CTPA).

Results: Data from 1,852 patients who were admitted to the hospital ward were collected. Forty patients (2.2%) were diagnosed with PE within 28 days following hospital admission. The median time to PE since admission was 4.5 days (IQR 0.0-9.0). In all 40 patients, PE was diagnosed within the first 2 weeks after hospital admission and for 22 (55%) patients within 2 weeks after onset of symptoms. Patient characteristics, pre-existing comorbidities, anticoagulant use, and laboratory parameters at admission were not related to the development of PE.

Conclusion: In this retrospective multicenter cohort study of 1,852 COVID-19 patients only admitted to the non-ICU wards, the incidence of CTPA-confirmed PE was 2.2% during the first 4 weeks after onset of symptoms and occurred exclusively within 2 weeks after hospital admission.

Keywords: COVID-19; Epidemiology; Hospital ward; Pulmonary embolism; Vascular research.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Kaplan-Meier curves with survival table for pulmonary embolism (PE) incidence for 28 days (a) since hospital admission and 42 days (b) since onset of symptoms in a non-ICU cohort of patients admitted to the hospital for COVID-19.
See this image and copyright information in PMC

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