Pulmonary Thromboembolism in pacients with COVID-19. Computer tomography pulmonary angiography: preliminary results
DOI:
https://doi.org/10.19230/jonnpr.3689Keywords:
COVID-19, coronavirus, pandemic, pulmonary thromboembolism, angioTCAbstract
Patients with severe pulmonary disease secondary to COVID-19 present with hipoxia and progressive increase of DDimero. For this reason these symptoms resemble pulmonary thromboembolism (TEP). AngioTC performance in these patients is complex and risky for the people involved. Clinical, analytical and image findings of patients with COVID-19 and pulmonary thromboembolism are reviewed.
Material and methods. This is a retrospective study of patients admitted in our hospitals with the diagnosis of COVID-19 in which an angioTC was practiced in order to confirm or discard TEP. Clinical and analytical parameters were analyzed.
Results. Eighteen angioTC of pulmonary arteries in admitted patients with COVID-19 between March 15 and April 10, 2020 were performed. Diagnosis was confirmed in all cases with PCR. The reason for consultation was hypoxemia and increase in DDimero with decrease in other parameters, usually altered in this disease (ferritin, LDH and protein C). TEP was confirmed in eight patients. Lobar and segmental branches were affected in five cases; in two, main and lobar arteries were involved. Pulmonary vein was thrombosed in one case. A tendency towards lymphopenia was observed in patients with thrombosis. 50% of patients were hospitalized in ICU. Small hilar and mediastinic lymph nodes were observed in all cases.
Conclusion. TEP is a complication in COVID-19 disease. Clinical diagnosis is difficult to establish due to overlapping of symptoms in both diseases. There is a tendency towards lymohopenia in patients with TEP.
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References
https://www.mscbs.gob.es/en/profesionales/saludPublica/ccayes/alertasActual/nCov-China/situacionActual.htm (entrada 14 abril 2020)
Tao Ai, Zhenlu Yang, HongyanHou, Chenao Zhan, Chong Chen, WenzhiLv, Qian Tao et all. Correlation of Chest CT and RT-PCR Testing in CoronavirusDisease 2019 (COVID-19) in China: A Report of 1014 Cases. In press
Kanne J P. Chest CT findings in 2019 Novel Coronavirus (2019-n CoV) infections from Wuhan, China: Key points for the radiologist.Radiology 2020; 295:16–17
https://www-uptodate-com.m-hmos.a17.csinet.es/contents/coronavirus-disease-2019-covid-19? search=covid%2019&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 (5 de abril de 2020)
Yang R, Li X, Zhen Y, Zhang X, Xiong Q, Luo Y, Gao C et al. Chest CT Severity score: An Imaging Tool for Assessing Severe COVID-19. Published Online:Mar 30 2020https://doi.org/10.1148/ryct.2020200047
https://www.bsti.org.uk/standards-clinical-guidelines/clinical-guidelines/bsti-covid-19-guidance-for-the- reporting-radiologist/ (entrada 15 abril 2020)
McIntosh K, Hirsch M, Bloom A. Coronavirus disease 2019 (COVID-19): Epidemiology, virology, clinical features, diagnosis, and prevention. Literature review current through: Mar 2020. | This topic last updated: Apr 16, 2020.
Fox S, Akmatbekov, Harbert, Li G, Brown Q, Vander Heide R. Pulmonary and Cardiac Pathology in COVID-19: The First Autopsy Series from New Orleans.doi: ttps://doi.org/10.1101/2020.04.06.20050575
Zuckier L, Moadel R, haramati L, Freeman L. Diagnostic Evaluation of Pulmonary Embolism During the COVID- 19 Pandemic.Journal of Nuclear Medicine, published on April 1, 2020 as doi:10.2967/jnumed.120.245571
Ishiguro T, Matsuo K, Fujii S , Takayanagi N. Acute thrombotic vascular events complicating influenza- associatedpneumonia. Acute thrombotic vascular events complicating influenza-associated pneumonia
Xie Y, Wang X, Yang P, Zhang S. COVID-19 Complicated by Acute Pulmonary Embolism. Radiology: Cardiothoracic Imaging 2020; 2(2):e200067 • https://doi.org/10.1148/ryct.2020200067
Chen J, Wang X, Zhang S, Liu B, Wu X, Wang Y et all.Findings of acute pulmonary embolism in COVID-19 patients. THELANCETID-D-20-00678
Kooraki S, Hosseiny M, Myers L, Gholamrezanezhad A. Coronavirus Outbreak: What the Department of Radiology Should Know. J Am CollRadiol 2020 in press
Ng KH, Wu AK, Cheng VC, et al. Pulmonary artery thrombosis in a patient with severe acute respiratory syndrome. Postgrad Med J. 2005;81:1–3.
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