Pulmonary Thromboembolism in COVID-19: a Cohort Analysis from a Tertiary Hospital in Chile

Main Article Content

Andres Giglio Jimenez
https://orcid.org/0000-0002-0533-4531
Rodrigo Naser Abarzua
https://orcid.org/0009-0004-4484-1992
José Del Campo Peirano
https://orcid.org/0009-0000-8581-1678
Patricio Astudillo Paredes
https://orcid.org/0000-0002-2600-630X
Francisca García Hoffmann
Isabel Hoffmann Weinberg
https://orcid.org/0009-0002-2080-798X

Abstract

Introduction: The risk of pulmonary thromboembolism (PTE) in hospitalized patients is well known, but SARS-COV-2 (COVID-19) pandemic has increased its incidence, with varying evidence describing a prevalence of PTE of 3-8%.


Methodology: Description of non-concurrent longitudinal cohort of hospitalized patients for SARS-COV2 infection with PTE in a tertiary complexity hospital. Clinical and epidemiological features were analyzed. 


Results: 151 patients were recruited with PTE and COVID-19 diagnosis, 3.4% of all hospitalized COVID patients. The median age was 67 years, 63% male patients, median length-of-stay (LOS) 20 days, and median time between COVID-19 to PTE diagnosis 13 days. Mortality at 30 days was PTE 17%, in-hospital mortality 23.1%. Mean PESI 107, Mean PESI of the deceased 116. Invasive mechanical ventilation prevalence was 31%.


Discussion: 3.4% incidence of PTE in the cohort is in the lower incidence described in other centers, considering that there was no systematic search strategy for PTE. The increased risk of in-hospital mortality and overall mortality is an alert on the possible clinical impact and may indicate the need for closer surveillance in this population.

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How to Cite
Giglio Jimenez, A., Naser Abarzua, R., Del Campo Peirano, J., Astudillo Paredes, P., García Hoffmann, F., & Hoffmann Weinberg, I. (2023). Pulmonary Thromboembolism in COVID-19: a Cohort Analysis from a Tertiary Hospital in Chile. Respirar, 15(4). https://doi.org/10.55720/respirar.15.4.2
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References

Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous Thromboembolism. A Public Health Concern. Am J Prev Med 2010;38: S495–501. Doi: 10.1016/j.amepre.2009.12.017.

Kopcke D, Harryman O, Benbow EW, Hay C, Chalmers N. Mortality from pulmonary embolism is decreasing in hospital patients. J R Soc Med 2011;104(8):327–31.

Burón Fernández MR, Pintor Holguín E, Minguez García P et al. Tromboembolismo pulmonar en pacientes hospitalizados entre 1994-2000: serie de autopsia. An Med Interna 2006; 23: 7.

Torbicki A. Pulmonary thromboembolic disease. Clinical management of acute and chronic disease. Rev Esp Cardiol 2010;63(7):832–49. DOI: 10.1016/s1885-5857(10)70168-7

de Cossio S, Paredes-Ruiz D, Gómez-Cuervo C et al. Clinical Differences and Outcomes of COVID-19 Associated Pulmonary Thromboembolism in Comparison with Non-COVID-19 Pulmonary Thromboembolism. J Clin Med 2022 ;11(20):6011. Doi:10.3390/jcm11206011

Deza EC, Parada CMT, Bitar HP et al. Caracterización clínica y tomográfica de pacientes hospitalizados con COVID-19. Rev Chil Enferm Respir 2021;37(1):26–34. Doi: 10.4067/S0717-73482021000100026

Nader E, Nougier C, Boisson C et al. Increased blood viscosity and red blood cell aggregation in patients with COVID‐19. Am J Hematol 2022; 97(3):283–92. Doi:10.1002/ajh.26440

Al-Kuraishy HM, Al-Gareeb AL, Al-hussaniy HA, Al-Harcan NAH, Alexiou A, Batiha GES. Neutrophil Extracellular Traps (NETs) and Covid-19: A new frontiers for therapeutic modality. Internat Immunopharmacol 2022; 104: 108516. Doi: 10.1016/j.intimp.2021.108516.

Philippe A, Chocron R, Gendron N et al. Circulating Von Willebrand factor and high molecular weight multimers as markers of endothelial injury predict COVID-19 in-hospital mortality. Angiogenesis 2021;24(3):505–17. Doi: 10.1007/s10456-020-09762-6

Ng JJ, Liang ZC, Choong AMTL. The incidence of pulmonary thromboembolism in COVID-19 patients admitted to the intensive care unit: a meta-analysis and meta-regression of observational studies. J Intensive Care 2021;9(1):20.

McGettrick M, Maclellan A, McCaughey P et al. Pulmonary thromboembolism in hospitalised patients with COVID-19: A retrospective national study of patients managed in critical care and ward environments in Scotland. BMJ Open 2021;11(8):e050281. Doi: 10.1136/bmjopen-2021-050281.

López Fontalvo J, Ballesteros Palencia SK, Coronado Pulido SY, Arias Botero JH. Incidence of venous thromboembolic events in patients hospitalized with COVID-19. Acta Colombiana de Cuidado Intensivo 2022;22:S11–8.

Zhan H, Chen H, Liu C et al. Diagnostic Value of D-Dimer in COVID-19: A Meta-Analysis and Meta-Regression. Clin Appl Thromb Hemost 2021;27:10760296211010976. Doi: 10.1177/10760296211010976.

Giglio A, Hoffmann I, Gutierrez F, Arriagada P. Reingresos Hospitalarios: Diagnosticando el Problema. Libro Resúmenes XXXVIII Congreso Chileno de Medicina Interna. 2017.

Jarman AF, Mumma BE, Singh KS, Nowadly CD, Maughan BC. Crucial considerations: Sex differences in the epidemiology, diagnosis, treatment, and outcomes of acute pulmonary embolism in non-pregnant adult patients. J Am Coll Emerg Physicians Open 2021; 27;2(1):e12378. Doi: 10.1002/emp2.12378. eCollection 2021 Feb.

Park TY, Jung JW, Choi JC et al. Epidemiological trend of pulmonary thromboembolism at a tertiary hospital in Korea. Korean J Intern Med 2017;32(6):1037–44. Doi: 10.3904/kjim.2016.248.

Pena E, Kimpton M, Dennie C, Peterson R, Le Gal G, Carrier M. Difference in interpretation of computed tomography pulmonary angiography diagnosis of subsegmental thrombosis in patients with suspected pulmonary embolism. Journal of Thrombosis and Haemostasis 2012; 10: 496–8. Doi: 10.1111/j.1538-7836.2011.04612.x.

Carrier M, Righini M, Wells PS et al. Subsegmental pulmonary embolism diagnosed by computed tomography: Incidence and clinical implications. A systematic review and meta-analysis of the management outcome studies. J Thromb Haemost 2010;8(8):1716–22. Doi: 10.1111/j.1538-7836.2010.03938.x.

Konstantinides SV, Meyer G, Bueno H et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European respiratory society (ERS). European Heart Journal 2020; 41: 543–603. Doi: 10.1093/eurheartj/ehz405

Donzé J, Le Gal G, Fine MJ et al. Prospective validation of the Pulmonary Embolism Severity Index: A clinical prognostic model for pulmonary embolism. Thromb Haemost 2008;100(5):943–8.

Aujesky D, Perrier A, Roy PM et al. Validation of a clinical prognostic model to identify low-risk patients with pulmonary embolism. J Intern Med 2007;261(6):597–604. Doi: 10.1111/j.1365-2796.2007.01785.x.

Muñoz OM, Ruiz-Talero P, Hernández-Florez C, Lombo-Moreno CE, Casallas-Rivera MA, Mayorga-Hernández CA. Validation of the PESI Scale to Predict in-Hospital Mortality in Patients with Pulmonary Thromboembolism Secondary to SARS CoV − 2 Infection. Clin Appl Thromb Hemost 2022;28:10760296221102940. Doi: 10.1177/10760296221102940.

Aujesky D, Obrosky DS, Stone RA et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 2005;172(8):1041–6. Doi: 10.1164/rccm.200506-862OC.