Radiological Determinants of Thromboembolic Events in COVID-19 Pneumonia: A Retrospective Study.

Background It has been established that patients with COVID-19 pneumonia are more vulnerable to developing thromboembolic complications. Computed tomography (CT) scan of the chest is an essential investigation modality in patients with COVID-19 pneumonia and has an important role in the diagnosis and identification of complications. Methods A retrospective observational study was conducted on patients admitted with COVID-19 pneumonia who underwent CT scans of the chest. The data regarding demographic information, clinical information, and CT findings were collected from electronic health records. Multivariable regression analysis was used to identify the independent factors associated with thromboembolic complications. Results The study included a total of 276 patients, including 178 (64.5%) men and 98 (35.5%) women. In total, 64 patients were found to have thromboembolic events, yielding a complication rate of 23.2%. Multivariable logistic regression revealed that patients aged 51-65 years (Odds ratio [OR] = 8.9; 95% confidence interval [CI]: 3.0-26.5) and >65 years (OR = 18.7; 95% CI: 7.6-46.1) had a higher likelihood of having thromboembolic complications compared to those aged 18-35 years. Further, the crazy-paving appearance of opacity was identified as an independent factor associated with thromboembolic events (OR = 14.2; 95% CI: 6.9-29.4). Further, patients with severe pulmonary parenchymal involvement were 30 times (OR = 30.6; 95% CI: 9.8-95.5) more likely to have thromboembolic complications compared with those having mild involvement. Conclusions The radiological findings on the CT scan of the chest can provide crucial prognostic information for patients with COVID-19 in terms of thromboembolic events. Clinicians need to keep a high index of suspicion for pulmonary embolism and deep venous thrombosis when they encounter patients with crazy-paving opacity appearances on CT scans, particularly among patients with severe parenchymal involvement.