Pulmonary embolism in hospitalized COVID-19 patients: Short- and long-term clinical outcomes
Introduction: Pulmonary embolism (PE) is a frequent complication in COVID-19. However, the influence of PE on the prognosis of COVID-19 remains unclear as previous studies were affected by misclassification bias. Therefore, we evaluated a cohort of COVID-19 patients whom all underwent systematic scr...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Thrombosis Update |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666572723000135 |
| _version_ | 1797739659733762048 |
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| author | Inge H.Y. Luu Jacqueline Buijs Jasenko Krdzalic Martijn D. de Kruif Guy J.M. Mostard Hugo ten Cate Tom P.J. Dormans Remy L.M. Mostard Math P.G. Leers Daan J.L. van Twist |
| author_facet | Inge H.Y. Luu Jacqueline Buijs Jasenko Krdzalic Martijn D. de Kruif Guy J.M. Mostard Hugo ten Cate Tom P.J. Dormans Remy L.M. Mostard Math P.G. Leers Daan J.L. van Twist |
| author_sort | Inge H.Y. Luu |
| collection | DOAJ |
| description | Introduction: Pulmonary embolism (PE) is a frequent complication in COVID-19. However, the influence of PE on the prognosis of COVID-19 remains unclear as previous studies were affected by misclassification bias. Therefore, we evaluated a cohort of COVID-19 patients whom all underwent systematic screening for PE (thereby avoiding misclassification) and compared clinical outcomes between patients with and without PE. Materials and methods: We included all COVID-19 patients who were admitted through the ED between April 2020 and February 2021. All patients underwent systematic work-up for PE in the ED using the YEARS-algorithm. The primary outcome was a composite of in-hospital mortality and ICU admission. We also evaluated long-term outcomes including PE occurrence within 90 days after discharge and one-year all-cause mortality. Results: 637 ED patients were included in the analysis. PE was diagnosed in 46 of them (7.2%). The occurrence of the primary outcome did not differ between patients with PE and those without (28.3% vs. 26.9%, p = 0.68). The overall rate of PE diagnosed in-hospital (after an initial negative PE screening in the ED) and in the first 90 days after discharge was 3.9% and 1.2% respectively. One-year all-cause mortality was similar between patients with and without PE (26.1% vs. 24.4%, p = 0.83). Conclusions: In a cohort of COVID-19 patients who underwent systematic PE screening in the ED, we found no differences in mortality rate and ICU admissions between patients with and without PE. This may indicate that proactive PE screening, and thus timely diagnosis and treatment of PE, may limit further clinical deterioration and associated mortality in COVID-19 patients. |
| first_indexed | 2024-03-12T14:01:25Z |
| format | Article |
| id | doaj.art-0a8fe48c847041f2b4576ff3b792ae51 |
| institution | Directory Open Access Journal |
| issn | 2666-5727 |
| language | English |
| last_indexed | 2024-03-12T14:01:25Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Thrombosis Update |
| spelling | doaj.art-0a8fe48c847041f2b4576ff3b792ae512023-08-22T04:07:02ZengElsevierThrombosis Update2666-57272023-08-0112100142Pulmonary embolism in hospitalized COVID-19 patients: Short- and long-term clinical outcomesInge H.Y. Luu0Jacqueline Buijs1Jasenko Krdzalic2Martijn D. de Kruif3Guy J.M. Mostard4Hugo ten Cate5Tom P.J. Dormans6Remy L.M. Mostard7Math P.G. Leers8Daan J.L. van Twist9Department of Internal Medicine, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the NetherlandsDepartment of Internal Medicine, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the NetherlandsDepartment of Radiology, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the NetherlandsDepartment of Pulmonology, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the NetherlandsDepartment of Internal Medicine, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the NetherlandsDepartment of Internal Medicine and Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, PO-box 616, 6200, MD, Maastricht, the NetherlandsDepartment of Intensive Care, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the NetherlandsDepartment of Pulmonology, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the NetherlandsDepartment of Clinical Chemistry and Haematology, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the NetherlandsDepartment of Internal Medicine, Zuyderland Medical Centre, PO-box 5500, 6130, MB, Sittard, the Netherlands; Corresponding author.Introduction: Pulmonary embolism (PE) is a frequent complication in COVID-19. However, the influence of PE on the prognosis of COVID-19 remains unclear as previous studies were affected by misclassification bias. Therefore, we evaluated a cohort of COVID-19 patients whom all underwent systematic screening for PE (thereby avoiding misclassification) and compared clinical outcomes between patients with and without PE. Materials and methods: We included all COVID-19 patients who were admitted through the ED between April 2020 and February 2021. All patients underwent systematic work-up for PE in the ED using the YEARS-algorithm. The primary outcome was a composite of in-hospital mortality and ICU admission. We also evaluated long-term outcomes including PE occurrence within 90 days after discharge and one-year all-cause mortality. Results: 637 ED patients were included in the analysis. PE was diagnosed in 46 of them (7.2%). The occurrence of the primary outcome did not differ between patients with PE and those without (28.3% vs. 26.9%, p = 0.68). The overall rate of PE diagnosed in-hospital (after an initial negative PE screening in the ED) and in the first 90 days after discharge was 3.9% and 1.2% respectively. One-year all-cause mortality was similar between patients with and without PE (26.1% vs. 24.4%, p = 0.83). Conclusions: In a cohort of COVID-19 patients who underwent systematic PE screening in the ED, we found no differences in mortality rate and ICU admissions between patients with and without PE. This may indicate that proactive PE screening, and thus timely diagnosis and treatment of PE, may limit further clinical deterioration and associated mortality in COVID-19 patients.http://www.sciencedirect.com/science/article/pii/S2666572723000135COVID-19Pulmonary embolismClinical outcomes |
| spellingShingle | Inge H.Y. Luu Jacqueline Buijs Jasenko Krdzalic Martijn D. de Kruif Guy J.M. Mostard Hugo ten Cate Tom P.J. Dormans Remy L.M. Mostard Math P.G. Leers Daan J.L. van Twist Pulmonary embolism in hospitalized COVID-19 patients: Short- and long-term clinical outcomes Thrombosis Update COVID-19 Pulmonary embolism Clinical outcomes |
| title | Pulmonary embolism in hospitalized COVID-19 patients: Short- and long-term clinical outcomes |
| title_full | Pulmonary embolism in hospitalized COVID-19 patients: Short- and long-term clinical outcomes |
| title_fullStr | Pulmonary embolism in hospitalized COVID-19 patients: Short- and long-term clinical outcomes |
| title_full_unstemmed | Pulmonary embolism in hospitalized COVID-19 patients: Short- and long-term clinical outcomes |
| title_short | Pulmonary embolism in hospitalized COVID-19 patients: Short- and long-term clinical outcomes |
| title_sort | pulmonary embolism in hospitalized covid 19 patients short and long term clinical outcomes |
| topic | COVID-19 Pulmonary embolism Clinical outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2666572723000135 |
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