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J Thromb Thrombolysis ; 51(1): 40-46, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32613385

RESUMEN

Recent studies suggest that thrombotic complications are a common phenomenon in the novel SARS-CoV-2 infection. The main objective of our study is to assess cumulative incidence of pulmonary embolism (PE) in non critically ill COVID-19 patients and to identify its predicting factors associated to the diagnosis of pulmonary embolism. We retrospectevely reviewed 452 electronic medical records of patients admitted to Internal Medicine Department of a secondary hospital in Madrid during Covid 19 pandemic outbreak. We included 91 patients who underwent a multidetector Computed Tomography pulmonary angiography(CTPA) during conventional hospitalization. The cumulative incidence of PE was assessed ant the clinical, analytical and radiological characteristics were compared between patients with and without PE. PE incidence was 6.4% (29/452 patients). Most patients with a confirmed diagnosed with PE recieved low molecular weight heparin (LMWH): 79.3% (23/29). D-dimer peak was significatly elevated in PE vs non PE patients (14,480 vs 7230 mcg/dL, p = 0.03). In multivariate analysis of patients who underwent a CTPA we found that plasma D-dimer peak was an independen predictor of PE with a best cut off point of > 5000 µg/dl (OR 3.77; IC95% (1.18-12.16), p = 0.03). We found ninefold increased risk of PE patients not suffering from dyslipidemia (OR 9.06; IC95% (1.88-43.60). Predictive value of AUC for ROC is 75.5%. We found a high incidence of PE in non critically ill hospitalized COVID 19 patients despite standard thromboprophylaxis. An increase in D-dimer levels is an independent predictor for PE, with a best cut-off point of > 5000 µg/ dl.


Asunto(s)
Anticoagulantes/uso terapéutico , Tratamiento Farmacológico de COVID-19 , COVID-19 , Quimioprevención , Pulmón , Embolia Pulmonar , COVID-19/complicaciones , COVID-19/diagnóstico , COVID-19/fisiopatología , Causalidad , Quimioprevención/métodos , Quimioprevención/estadística & datos numéricos , Angiografía por Tomografía Computarizada/métodos , Registros Electrónicos de Salud/estadística & datos numéricos , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , Pulmón/irrigación sanguínea , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Embolia Pulmonar/sangre , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/epidemiología , Embolia Pulmonar/etiología , SARS-CoV-2/aislamiento & purificación , España/epidemiología , Trombofilia/diagnóstico , Trombofilia/etiología
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