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European Radiology

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01-11-2020 | Acute Pulmonary Embolism | Chest

Acute pulmonary embolism in non-hospitalized COVID-19 patients referred to CTPA by emergency department

Authors: Alban Gervaise, Caroline Bouzad, Evelyne Peroux, Carole Helissey

Published in: European Radiology | Issue 11/2020

Abstract

Objectives

To evaluate the prevalence of acute pulmonary embolism (APE) in non-hospitalized COVID-19 patients referred to CT pulmonary angiography (CTPA) by the emergency department.

Methods

From March 14 to April 6, 2020, 72 non-hospitalized patients referred by the emergency department to CTPA for COVID-19 pneumonia were retrospectively identified. Relevant clinical and laboratory data and CT scan findings were collected for each patient. CTPA scans were reviewed by two radiologists to determinate the presence or absence of APE. Clinical classification, lung involvement of COVID-19 pneumonia, and CT total severity score were compared between APE group and non-APE group.

Results

APE was identified in 13 (18%) CTPA scans. The mean age and D-dimer of patients from the APE group were higher in comparison with those from the non-APE group (74.4 vs. 59.6 years, p = 0.008, and 7.29 vs. 3.29 μg/ml, p = 0.011). There was no significant difference between APE and non-APE groups concerning clinical type, COVID-19 pneumonia lung lesions (ground-glass opacity: 85% vs. 97%; consolidation: 69% vs. 68%; crazy paving: 38% vs. 37%; linear reticulation: 69% vs. 78%), CT severity score (6.3 vs. 7.1, p = 0.365), quality of CTPA (1.8 vs. 2.0, p = 0.518), and pleural effusion (38% vs. 19%, p = 0.146).

Conclusions

Non-hospitalized patients with COVID-19 pneumonia referred to CT scan by the emergency departments are at risk of APE. The presence of APE was not limited to severe or critical clinical type of COVID-19 pneumonia.

Key Points

• Acute pulmonary embolism was found in 18% of non-hospitalized COVID-19 patients referred by the emergency department to CTPA. Two (15%) patients had main, four (30%) lobar, and seven (55%) segmental acute pulmonary embolism.

• Five of 13 (38%) patients with acute pulmonary embolism had a moderate clinical type.

• Severity and radiological features of COVID-19 pneumonia showed no significant difference between patients with or without acute pulmonary embolism.

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Title: Acute pulmonary embolism in non-hospitalized COVID-19 patients referred to CTPA by emergency department
Authors: Alban Gervaise
Caroline Bouzad
Evelyne Peroux
Carole Helissey
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Acute Pulmonary Embolism
Acute Pulmonary Embolism
Acute Pulmonary Embolism
Pneumonia
COVID-19
Published in: European Radiology / Issue 11/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06977-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Acute pulmonary embolism in non-hospitalized COVID-19 patients referred to CTPA by emergency department

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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