Features of patients newly diagnosed pulmonary embolism during COVID pneumonia

Abstract

Aim: Evidences showed that coronavirus disease 2019 (COVID-19) can cause increased coagulopahty due to many different mechanisms. We aimed to identfy features of patients newly diagnosed pulmonary embolism (PE) during COVID pneumonia and evaluate prognosis of those patients.

Method: We conducted a multicenter retrospective study and examined files of patients who was diagnosed with PE within 45 days after or at the same time the diagnosis of COVID pneumonia.

Results: 38 (36,9%) of patients was women and mean age was 59,8 years. 47 (45,6%) of patients had severe COVID pneumonia and 43 (41,7%) of patients had bilateral expansive infiltrations. 62 (60,2%) of patients had at least one comorbidity and macrophage activation syndrome occured 16 (15,5%) of all patients. In the 33 (32%) of patients, PE was diagnosed at the same time with COVID pneumonia. Mean PE occuring time was 8,8 days after COVID diagnosis. 37 (35,9%) of patients was taking anticoagulant prophylaxis. D-dimer levels of patients was 5,5 times the upper limit of normal at the beginning of the COVID pneumonia and 9,7 at the diagnosis of PE. Most of patients had thrombus in the bilateral or unilateral segmental/subsegmental arteries. 60 (58,3%) of patients had low PE early mortality risk. For PE treatment 79 (76,7%) of patients used low moleculer weight heparin, 16 (15,5%) unfractioned heparin and 8 (7,8%) direct oral anticoagulant. 7 (6,8%) of patients needed thrombolytic therapy. Mortality rate was 7,8%.

Conclusion: We revealed characteristics of patients newly diagnosed PE during COVID pneumonia. Further studies ar needed to assess incidence of PE and factors releated with mortality in those patients.