Pulmonary thromboembolic disease in COVID-19 patients on CT pulmonary angiography – Prevalence, pattern of disease and relationship to D-dimer
| العنوان: | Pulmonary thromboembolic disease in COVID-19 patients on CT pulmonary angiography – Prevalence, pattern of disease and relationship to D-dimer |
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| المؤلفون: | A. Rajai, S.Y. Liong, R. Patel, N. Gerova, V. Godhamgaonkar, M.W.X. Ooi |
| المصدر: | European Journal of Radiology |
| بيانات النشر: | Elsevier BV, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Computed Tomography Angiography, PTE, Pulmonary thromboembolism, Disease, Severity of Illness Index, Gastroenterology, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Prevalence, SD, Standard deviation, Medicine, Young adult, CTPA, Computed tomography pulmonary angiogram, Aged, 80 and over, Incidence (epidemiology), General Medicine, Middle Aged, Pulmonary embolism, FPR, False positive rate, medicine.anatomical_structure, Radiology Nuclear Medicine and imaging, 030220 oncology & carcinogenesis, Female, DVT, Deep vein thrombosis, Coronavirus Infections, Research Article, Adult, medicine.medical_specialty, Pneumonia, Viral, Pulmonary Artery, Sensitivity and Specificity, COVID-19, SARS-CoV-2 disease 2019, Fibrin Fibrinogen Degradation Products, Betacoronavirus, Young Adult, 03 medical and health sciences, Thromboembolism, Internal medicine, Severity of illness, D-dimer, Humans, Radiology, Nuclear Medicine and imaging, TPR, True positive rate, Pandemics, Aged, Retrospective Studies, BSTI, British Society of Thoracic Imaging, Lung, SARS-CoV-2, business.industry, COVID-19, Retrospective cohort study, IQR, Interquartile range, RT-PCR, Reverse transcriptase polymerase chain reaction, medicine.disease, Coronavirus, business |
| الوصف: | Highlights • Prevalence of pulmonary thromboembolic disease (PTE) is 38% in COVID-19 patients who underwent CTPA. Patients with more severe COVID-19 changes are more likely to have PTE. • Majority of PTE is observed within smaller pulmonary vessels (75%) and lungs demonstrating COVID-19 changes (72%). Subsegmental vessels should be scrutinized for presence of PTE. • D-dimer values may have potential in guiding anticoagulation therapy and evaluating prognosis in these patients. Objectives To define the prevalence of pulmonary thromboembolic (PTE) disease diagnosed on CT pulmonary angiography (CTPA) in COVID-19 patients. To assess distribution of PTE and to evaluate for association between severity of COVID-19 disease, D-dimer values and incidence of PTE. Methods Patients with diagnosis of COVID-19 presenting to 5 different hospitals across Greater Manchester between 1st March 2020 and 30th April 2020 who had CTPA were included. CTPA images were evaluated for presence of PTE, distribution of PTE (in small and/or large vessels) and distribution of PTE within lungs with or without COVID-19 CT changes. Severity of COVID lung changes were graded. D-dimer values within 72 hours of CTPA were obtained. Statistical analyses were performed to evaluate for any significant association between variables. p values of ≤ 0.05 were regarded as statistically significant. Results A total of 974 patients presented across five hospital sites with COVID-19 infection. Eighty-four (n = 84) COVID-19 patients underwent CTPA. Of these, 38% (32/84) had PTE. PTE was seen in small vessels in 75% (24/32) and in lungs demonstrating COVID-19 changes in 72% (23/32). 84% (27/32) of PTE positive patients had disease severity of moderate or higher score (p = 0.005). D-dimer values were significantly higher (p ≤ 0.001) in PTE patients, median value in PTE group was 6441mcg/L(range219-90925). A D-dimer cut off value of 2247mcg/L provides sensitivity of 0.72 and specificity of 0.74. Conclusion There is increased prevalence of PTE in patients with moderate to severe COVID-19 disease. D-dimer values may have potential in guiding anticoagulation therapy and prognostication. |
| تدمد: | 0720-048X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0a979b2558751e4dee99334699a9ff49 https://doi.org/10.1016/j.ejrad.2020.109336 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....0a979b2558751e4dee99334699a9ff49 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 0720048X |
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