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Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area

PURPOSE: To analyze pulmonary embolism (PE) on chest computed tomography pulmonary angiography (CTPA) in hospitalized patients affected by SARS-CoV-2, according to the severity of lung disease based both on temporal CT features changes and on CT-severity lung involvement (CT-severity score), along w...

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Autores principales: Ippolito, Davide, Giandola, Teresa, Maino, Cesare, Pecorelli, Anna, Capodaglio, Carlo, Ragusi, Maria, Porta, Marco, Gandola, Davide, Masetto, Alessandro, Drago, Silvia, Allegranza, Pietro, Corso, Rocco, Talei Franzesi, Cammillo, Sironi, Sandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790932/
https://www.ncbi.nlm.nih.gov/pubmed/33417194
http://dx.doi.org/10.1007/s11547-020-01328-2
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author Ippolito, Davide
Giandola, Teresa
Maino, Cesare
Pecorelli, Anna
Capodaglio, Carlo
Ragusi, Maria
Porta, Marco
Gandola, Davide
Masetto, Alessandro
Drago, Silvia
Allegranza, Pietro
Corso, Rocco
Talei Franzesi, Cammillo
Sironi, Sandro
author_facet Ippolito, Davide
Giandola, Teresa
Maino, Cesare
Pecorelli, Anna
Capodaglio, Carlo
Ragusi, Maria
Porta, Marco
Gandola, Davide
Masetto, Alessandro
Drago, Silvia
Allegranza, Pietro
Corso, Rocco
Talei Franzesi, Cammillo
Sironi, Sandro
author_sort Ippolito, Davide
collection PubMed
description PURPOSE: To analyze pulmonary embolism (PE) on chest computed tomography pulmonary angiography (CTPA) in hospitalized patients affected by SARS-CoV-2, according to the severity of lung disease based both on temporal CT features changes and on CT-severity lung involvement (CT-severity score), along with the support of clinical and laboratory findings. METHODS: We retrospectively enrolled a total of 170 patients with confirmed SARS-CoV-2 infection who underwent CTPA examination for PE suspicion. Pulmonary arteries diameters, right ventricle/left ventricle (RV/LV) ratio, presence, absence, and distribution of PE, pulmonary artery obstructive index (PAO index), and lobe involvement were recorded. All CT scans were reviewed to assess temporal CT changes and the COVID CT-severity score. RESULTS: A total of 76 out of 170 patients (44.7%) developed PE without having any major risk factors for venous thromboembolism. The most severe pulmonary arteries involvement, expressed in terms of PAO Index, occurred in those patients with markedly elevated D-dimer and C-reactive protein (CRP) values and those patients with an advanced temporal stage of lung disease. The majority PE-positive patients were hospitalized in non-intensive wards. PE-positive patients showed a slightly higher hospitalization time in comparison with PE-negative ones. In the three months of study, overall 85.9% of patients were discharged while 14.1% died, of whom 13 PE-positive (54.2%). CONCLUSIONS: Patients hospitalized for SARS-CoV-2 infection present a higher cumulative incidence of PE compared to the general population of hospitalized patients, regardless of the severity of lung inflammation or the temporal stage of the disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at (10.1007/s11547-020-01328-2).
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spelling pubmed-77909322021-01-08 Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area Ippolito, Davide Giandola, Teresa Maino, Cesare Pecorelli, Anna Capodaglio, Carlo Ragusi, Maria Porta, Marco Gandola, Davide Masetto, Alessandro Drago, Silvia Allegranza, Pietro Corso, Rocco Talei Franzesi, Cammillo Sironi, Sandro Radiol Med Chest Radiology PURPOSE: To analyze pulmonary embolism (PE) on chest computed tomography pulmonary angiography (CTPA) in hospitalized patients affected by SARS-CoV-2, according to the severity of lung disease based both on temporal CT features changes and on CT-severity lung involvement (CT-severity score), along with the support of clinical and laboratory findings. METHODS: We retrospectively enrolled a total of 170 patients with confirmed SARS-CoV-2 infection who underwent CTPA examination for PE suspicion. Pulmonary arteries diameters, right ventricle/left ventricle (RV/LV) ratio, presence, absence, and distribution of PE, pulmonary artery obstructive index (PAO index), and lobe involvement were recorded. All CT scans were reviewed to assess temporal CT changes and the COVID CT-severity score. RESULTS: A total of 76 out of 170 patients (44.7%) developed PE without having any major risk factors for venous thromboembolism. The most severe pulmonary arteries involvement, expressed in terms of PAO Index, occurred in those patients with markedly elevated D-dimer and C-reactive protein (CRP) values and those patients with an advanced temporal stage of lung disease. The majority PE-positive patients were hospitalized in non-intensive wards. PE-positive patients showed a slightly higher hospitalization time in comparison with PE-negative ones. In the three months of study, overall 85.9% of patients were discharged while 14.1% died, of whom 13 PE-positive (54.2%). CONCLUSIONS: Patients hospitalized for SARS-CoV-2 infection present a higher cumulative incidence of PE compared to the general population of hospitalized patients, regardless of the severity of lung inflammation or the temporal stage of the disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at (10.1007/s11547-020-01328-2). Springer Milan 2021-01-08 2021 /pmc/articles/PMC7790932/ /pubmed/33417194 http://dx.doi.org/10.1007/s11547-020-01328-2 Text en © Italian Society of Medical Radiology 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Chest Radiology
Ippolito, Davide
Giandola, Teresa
Maino, Cesare
Pecorelli, Anna
Capodaglio, Carlo
Ragusi, Maria
Porta, Marco
Gandola, Davide
Masetto, Alessandro
Drago, Silvia
Allegranza, Pietro
Corso, Rocco
Talei Franzesi, Cammillo
Sironi, Sandro
Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area
title Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area
title_full Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area
title_fullStr Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area
title_full_unstemmed Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area
title_short Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area
title_sort acute pulmonary embolism in hospitalized patients with sars-cov-2-related pneumonia: multicentric experience from italian endemic area
topic Chest Radiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790932/
https://www.ncbi.nlm.nih.gov/pubmed/33417194
http://dx.doi.org/10.1007/s11547-020-01328-2
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