Patient Characteristics and Predictors of Pulmonary Embolism in Patients Infected with COVID – 19 in Upper Egypt

Abstract

Background

A little is known about the risk factors and predictors of pulmonary embolism (PE) in Coronavirus disease 2019 (Covid-19) infected patients. Therefore, we directed this study to investigate the predictors of PE in patients infected with Covid – 19 in Upper Egypt.

Methods

We conducted a retrospective cohort study on 297 patients infected with COVID-19, aged ≥ 18 years old. Suspicion of COVID-19 infection was based on the World Health Organization (WHO) criteria and confirmed by nasal and pharyngeal swab for real-time reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. The patient was also determined to have COVID-19 when CT results that were thought to be typical for COVID-19 and clinical data that were compatible were present.

Results

PE was diagnosed in 18.2% of patients. We found that the incidence of PE was significantly higher in older patients, females, those with higher BMI, hypertensive patients, diabetics, and patients with co-morbidities. Also, PE was significantly higher in patients presented with dyspnea, chest pain, longer duration of symptoms at hospital admission, and lower oxygen concentration. The mean serum Hb level, platelet count, TLC and absolute lymphocytic count were markedly reduced in those who had PE. All the patients who developed PE had a CO-RADS scale five on their CT chest scan. Age > 65, BMI > 25, DM, and associated co-morbidities were the independent patients’ characteristics associated with the development of PE after the multivariate regression analysis.

Conclusion

PE is a common complication of Covid 19 infection. PE is associated with a variety of clinical and laboratory parameters in univariate analysis, but age > 65, BMI > 25, DM, and associated co-morbidities were the independent patients’ characteristics associated with the development of PE in those infected with Covid-19.

Keywords:

• Covid-19
• SARS-CoV-2
• CO-RADS
• pulmonary embolism

Abbreviations

ACE, angiotensin converting enzyme; AUC, area under the curve; Covid-19, coronavirus disease 2019; CT, computerized tomography; CTPA, computerized tomography pulmonary angiography; DIC, disseminated intravascular coagulopathy; DM, diabetes mellitus; PE, pulmonary embolism; ROC curve, receiver operating characteristic curve; RV, right ventricle; BMI, body mass index; sPAP, systolic pulmonary artery pressure; TAPSE, Tricuspid annular plane systolic excursion; TLC, total leucocytic count; WHO, World Health Organization.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

The need for informed consent was waived due to the retrospective design of the study. The study protocol was approved by: Beni Suef’s Faculty of Medicine ethics committee. The approval number is: FMBSUREC/01022022/Awad. Date of approval, February 2022.

Acknowledgments

We thank all the hospitals’ team who provided us with the required data and registries.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in All these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

There are no conflicts of interest among the authors in this study.

Additional information

Funding

There is no funding to report.