Pulmonary Embolism in Hospitalised Patients with COVID-19

Title: Pulmonary Embolism in Hospitalised Patients with COVID-19
Author(s): Garvey S, Roche S, Campbell C, Toland S, Gunaratnam C, O’Brien ME, Cushen B, Morgan R, Costello R, Hurley K, McElavney G, Ryan D, Branagan P, Sulaiman I.
Institution: Beaumont Hospital
Poster: Click to view poster
Category: COVID 19
Abstract: Pulmonary embolism (PE) is a recognised complication of SARS-CoV-2 infection, particularly in hospitalised patients. Here we performed a retrospective review of Wave 1 (W1, March – May 2020) & Wave 3 (January 2021) of COVID-19 admissions: patient demographics, imaging, d-dimer levels & illness severity was recorded. Data collection is ongoing.

During W1, 318 SARS-CoV-2 positive patients were admitted to Beaumont Hospital, and 222 during W3. Of these patients, 41 (13%) in W1 and 59 (27%) in W3 had a CT-pulmonary-angiogram (CTPA) to diagnose a PE (this compares to 35% internationally). There was a 46% positivity rate in W1 and 27.11% in W3. CTPA positivity was as follows: 50% W3, 55% W1 in ICU patients, 29% W3, 40% W1 for patients on non-invasive-ventilation and 21% W3, 33% W1 on ward-based supportive care. Of the PEs identified in W3, 68.75% were segmental and 75% bilateral. Radiographic evidence of right heart strain was noted in 43.75%. The overall incidence rate of PE was 5% in W1, compared to 7% in W3.

In this study, by W3 of the COVID19 pandemic the incidence rate of PE increased while the positivity rate decreased, consistent with increased awareness of PE in SARS-CoV-2 infection & increased level of CT imaging. This incidence rate is comparable to that reported internationally.