Pulmonary embolism during SARS-CoV-2 pandemic: Clinical and radiological features

Tromboembolismo pulmonar durante la pandemia por SARS-CoV-2: características clínicas y radiológicas

A. García-Lledóa,b,

Corresponding author

[e-mail]

Corresponding author.

, M. del Palacio-Salgadoc, C. Álvarez-Sanzb,c, M.M. Pérez-Gila, Á. Cruz-Díazb,c

a Servicio de Cardiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain

b Departamento de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain

c Servicio de Radiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain

Abstract

Background

A high incidence of pulmonary embolism has been described during the coronavirus pandemic.

Methods

This work is a single-center retrospective study which reviewed computed tomography pulmonary angiograms ordered due to suspected pulmonary embolism during two periods: from March 1, 2020 to May 31, 2020 (pandemic) and during the same interval in 2019 (control).

Results

Twenty-two pulmonary embolisms were diagnosed during the control period and 99 in the pandemic, 74 of which were associated with COVID-19. Of all patients hospitalized with COVID-19, 5.3% had a pulmonary embolism, with a delay between the two diagnoses of 9.1 ± 8.4 days. During the pandemic, patients with pulmonary embolism had fewer predisposing conditions (previous pulmonary embolism 5.1 vs. 18.2%, p = .05; previous surgery 2 vs. 35.4%, p = .0001; deep vein thrombosis 11.1 vs. 45.5%, p = .0001); peripheral pulmonary embolisms were the most frequent (73.5 vs. 50%, p = . 029).

Conclusions

There is an increased risk of having a pulmonary embolism during the SARS-CoV-2 pandemic, which affects patients with a different clinical profile and more often causes distal pulmonary embolisms.

Keywords:

COVID-19

Pulmonary embolism

SARS-CoV-2

Coronavirus

Thrombosis

Resumen

Antecedentes

Se ha descrito una elevada incidencia de tromboembolismo pulmonar (TEP) durante la pandemia por coronavirus.

Métodos

Estudio retrospectivo unicéntrico, con revisión de las angiografías pulmonares por tomografía computarizada solicitadas por sospecha de tromboembolismo pulmonar durante dos períodos, del 01 de marzo del 2020 al 31de mayo del 2020 (pandemia), e igual intervalo en 2019 (control).

Resultados

Se diagnosticaron 22 tromboembolismos pulmonares durante el período control y 99 en el pandémico, 74 asociados con COVID-19. El 5,3% de los pacientes hospitalizados con COVID-19 sufrió un tromboembolismo pulmonar, con un retraso entre ambos diagnósticos de 9,1 ± 8,4 días. Durante la pandemia, los pacientes con tromboembolismo pulmonar tenían menos condiciones predisponentes (tromboembolismo pulmonar previo 5,1 vs. 18,2%, p = 0,05, cirugía previa 2 vs. 35,4%, p = 0,0001, trombosis venosa profunda 11,1 vs. 45,5%, p = 0,0001), y los tromboembolismos pulmonares periféricos eran más frecuentes (73,5 vs. 50%, p = 0,029).

Conclusiones

Existe un riesgo incrementado de sufrir un TEP durante la pandemia por SARS-CoV-2, que afecta a pacientes con perfil clínico diferente y causa más frecuentemente TEP distales.

Palabras clave:

COVID-19

Embolismo pulmonar

SARS-CoV-2

Coronavirus

Trombosis