The effect of the COVID-19 pandemic on CTPA use in an academic medical centre

Title: The effect of the COVID-19 pandemic on CTPA use in an academic medical centre
Author(s): Brian Gaffney, John Duignan, Finbarr Conroy, Peter Conlon, Evelyn Lynn, Marcus W. Butler, Michael P Keane, Jonathan D Dodd, David J Murphy, Alessandro N Franciosi, Cormac McCarthy
Institution: St Vincent's University Hospital
Poster: Click to view poster
Category: COVID-19
Abstract: INTRODUCTION: COVID-19 profoundly affected healthcare services and their utilisation. It has been hypothesised that COVID-19 is associated with increased risk of pulmonary embolism(PE). We assessed how COVID-19 pandemic affected CTPA utilisation and if more PE were diagnosed in COVID-19 positive patients
METHODS: Data for patients who underwent CTPA between January-May 2020 were analysed, including; age, sex, COVID-19 status, WCC, CRP and D-dimer. COVID-19 status was coded as Non-COVID pathway(NC), SARS-CoV-2 negative(NEG), and SARS-CoV-2 positive(POS). Data was analysed using RStudio.
RESULTS: 454 patients were included. More CTPA scans were performed in the second month of the pandemic(n=158) compared to the initial month(n=95). Prevalence of CTPA-defined PE (17.4% vs 14.9% vs 13.6% for POS/NEG/NC respectively, p=ns) and adjusted odds of PE (OR 1.16[95% CI; 0.45-3.0] and 1.21[95% 0.21-7.03] for NEG and POS respectively vs NC] did not differ between groups . Interestingly, SARS-CoV-2 POS patients with negative CTPA had significantly lower D-dimers (median=0.75[0.65,0.97]) compared to NEG or NC patients (median.91[0.42, 1.52] & 1.04[0.69,1.57] respectively, p=0.032).
DISCUSSION: The purported increased risk of PE in COVID-19 possibly resulted in an increase CTPAs performed as the pandemic evolved. Interestingly there was no increase in PE incidence and paradoxically COVID-19 patients were scanned with lower D-dimers.