Elevated D-Dimer and acute pulmonary embolism in COVID-19 patients

Authors

  • Yoselin Dos Santos-Poleo Department of Diagnostic Imaging of Hospital General de Segovia, Segovia, Spain.
  • Lorenzo Pérez-Sánchez Department of Diagnostic Imaging of Hospital General de Segovia, Segovia, Spain
  • Abrahams Ocanto Radiation Oncology Department of Hospital Universitario La Paz, Madrid, Spain. https://orcid.org/0000-0002-6494-8197
  • Diana Oquillas-Izquierdo Department of Diagnostic Imaging of Hospital General de Segovia, Segovia, Spain
  • Francisco Rodríguez-Recio Department of Diagnostic Imaging of Hospital General de Segovia, Segovia, Spain

DOI:

https://doi.org/10.19230/jonnpr.3960

Keywords:

COVID-19, embolism, CT scan, D-dimer, radiology

Abstract

Introduction. It has been determined that patients with SARS-CoV-2 infection and severe pneumonia with elevated D-dimer values can develop acute pulmonary thromboembolism (APE) as a complication, being one  of the causes related to mortality in this group of patients.

Methods. A retrospective analysis of 12 patients diagnosed with SARS-CoV-2 infection with high clinical suspicion of APE confirmed by computed tomography pulmonary angiopgraphy (CTPA) was performed and  the described findings are described.

Results. 12 patients with diagnosis of severe pneumonia, elevated D-dimer 9.2 ?g / ml (1.4 - ?20 ?g / mL) and confirmation of SARS-CoV-2 infection through real-time reverse transcription polymerasa chain reaction (RT- PCR). APEs were observed mainly in segmental arteries (75%) and main arteries (25%). Pneumonia with  patched areas of bilateral ground glass opacities was observed in 100% of the sample as a typical finding of  SARS-CoV-2 infection.

Conclusion. SARS-CoV-2 infection is related to elevation of D-dimer and APE. The CTPA determines the  diagnosis, severity and timely management (anticoagulation) of patients with APE. Therefore CTPA should be  considered in all patients with elevated D-dimer or clinical worsening.

 

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Published

2020-08-29