P46 SARS-COV-2 – a major risk factor for pulmonary embolism, a retrospective observational study from a single tertiary care hospital. (11th November 2022) - Azam, R
Abstract : Introduction: Pulmonary Embolism (PE) is a well-known respiratory complication with incidence around 60–70 per 100, 000 globally. During the pandemic, SARS-COV-2 emerged as a substantial risk factor for PE. 1, 2 The objective of this study is to depict the incidence of PE in patients with COVID-19 illness in a tertiary hospital for the period of October-December 2020. Methods: In this retrospective cross-sectional observational study, all patients who presented to the UHL trust between October 2020 and December 2020 with a suspicion of PE were included. Of 1062 CTPA requests, 132 were disregarded, and 930 participants with CTPA were reviewed. Results: Out of 930 Patients (543 female and 519 male), 621 were non-covid while 309 were covid patients. Total incidence of PE in this study was 14.6%(136/930). 13.3%(41/309) of the covid patients had PE, (25 with positive swab and 16 radiological diagnosis). Along with covid infection, 4 of these patients also had additional risk factors (3 malignancy, 1 recent Endoscopy). Of the 621 non-covid patients, 15.3%(95/621) developed PE. In the PE cohort, none of the patients had recent COVID Vaccination. Of 41 covid patients with PE, 28 were men and 13 women. 12 patients required higher respiratory assistance (1 death); 5 required ICU admission, 5 required CPAP support and 2 required high flow oxygen. In terms of clot burden, 14 had light burden, 6 had moderate burden, and remaining (21) had a high burden (6 had right heart strain). Comparing D-dimer values, 2 had readings ≤1 mcg/mL, 5 between 1–2 mcg/mL, 12 between 2–5 mcg/mL, 5 between 5–10 mcg/mL, 3 between 10–20 mcg/mL, 9 had readings ≥20 mcg/mL and remaining (5) were clinically suspected. Conclusion: Covid-19 has been identified as a significant risk factor for PE. These patients must be anti-coagulated in order to avoid various complications, including life-threatening arrhythmias, severe hypoxemia, shock, even death. References: Jevnikar M, et al . Prevalence of pulmonary embolism in patients with COVID-19 at the time of hospital admission. European Respiratory Journal 2021 Jul 1;58 (1). Katsoularis I, et al. Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: nationwide self-controlled cases series and matched cohort study. BMJ 2022 Apr 6;377 .