Pulmonary embolism and COVID-19

INTRODUCTION: SARS-CoV-2 infection induces thromboembolic complications secondary to the alteration of the endothelium, causes a state of hypercoagulability by increasing the level of coagulation factors and circulating cytokines and hospitalization and the placement of a catheter are contributing factors. OBJECTIVE: Describe the incidence of pulmonary embolism in the population infected with COVID 19, specify these clinico-radiological characteristics and these risk factors. METHOD: This is a descriptive prospective study spread over 6 months including 1,252 patients hospitalized in intensive care, intensive care and medical services. RESULTS: Eighty-nine (7.01%) patients were diagnosed with pulmonary embolism, 59.55% of them were male and the mean age of patients was 55.2 years. In terms of comorbidities, 31 patients were hypertensive (34.83%), 9 diabetic patients (10.11%), 19 patients (21.34%) obese, 19 patients (21.34%) smokers, 12 patients (13.48%) have a history of heart disease, 5 patients (5.62%) of the patients diagnosed had active cancer. In terms of symptoms dyspnea: 81 patients (91.01%), palpitations: 49 patients (55.06%), chest pain: 21 patients (23.60%), hemoptysis: 7 patients (7.86%), signs of right heart failure: 3 patients (3.37%), signs of circulatory failure: 2 patients (2.25%). Electrically sinus tachycardia: 68 patients (76.40%), electrical right atrial hypertrophy: 21 patients (23.60%), electrical right ventricular hypertrophy: 19 patients (21.35%), right bundle branch block: 18 patients (20.22%), right axis deviation: 21 patients (23.60%), S1Q3 aspect: 16 patients (17.98%), atrial fibrillation: 8 patients (8.99%), biologically: mean d-dimer value was 2523.4 ng/L, 12.4% had positive troponin. On chest CT, 8.9% had moderate (10–25%), 24.74% had extensive (25–50%), 40.46% had severe (50–75%), 24.74% had critical (> 75%), on CT angiography in (52.93%) the thrombus was located on a lobar bronchus. CONCLUSION: Our study confirmed the high incidence of pulmonary embolism in the context of SARS-CoV-2 infection. Hypertension, obesity, the presence of a previous heart disease and active neoplasia are, according to our study, real risk factors for pulmonary embolism. Dyspnea, palpitations, chest pains of rapid installation direct towards the very probable existence of a pulmonary embolism. D-dimers are factors that significantly increase the pre-test probability of embolism, troponin has essentially a prognostic value.