CT pulmonary angiography in COVID-19 pneumonia: relationship between pulmonary embolism and disease severity

• Published in: Egyptian Journal of Radiology and Nuclear Medicine Vol. 52; no. 1; pp. 10 - 8
• Main Authors: Yassin, Aya, Abdelkader, Maryam Ali, Mohammed, Rehab M., Osman, Ahmed M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 05.01.2021; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Age; Angiography; Bacterial pneumonia; Coronaviruses; COVID-19; CT imaging; CT pulmonary angiography (CTPA); D-dimer; Disease control; Dyspnea; Health aspects; Hemoptysis; Imaging; Infections; Laboratories; Lymphocytes; Medical imaging; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Neutrophils; Nuclear Medicine; Patients; Pneumonia; Pulmonary arteries; Pulmonary embolism; Pulmonary embolism (PE); Pulmonary embolisms; Radiology; Egypt; United States > US; COVID-19; D-dimer; CT pulmonary angiography (CTPA); Pulmonary embolism (PE)
• ISSN: 0378-603X; 2090-4762
• DOI: 10.1186/s43055-020-00389-7

Background Pulmonary embolism (PE) is one of the known sequels of COVID-19 infection. We aimed to assess the incidence of PE in patients with COVID-19 infection and to evaluate the relationship between the CT severity of the disease and the laboratory indicators. This was a retrospective study conducted on 96 patients with COVID-19 infection proved by positive PCR who underwent CT pulmonary angiography (CTPA) with a calculation of the CT severity of COVID-19 infection. Available patients’ complaint and laboratory data at the time of CTPA were correlated with PE presence and disease severity. Results Forty patients (41.7%) showed positive PE with the median time for the incidence of PE which was 12 days after onset of the disease. No significant correlation was found between the incidence of PE and the patients’ age, sex, laboratory results, and the CT severity of COVID-19. A statistically significant relation was found between the incidence of PE and the patients’ desaturation, hemoptysis, and chest pain. A highly significant correlation was found between the incidence of PE and the rising in the D-dimer level as well as the progressive CT findings when compared to the previous one. Conclusion CT progression and the rising in D-dimer level are considered the most important parameters suggesting underlying PE in patients with positive COVID-19 infection which is commonly seen during the second week of infection and alert the use of CT pulmonary angiography to exclude or confirm PE. This is may help in improving the management of COVID-19 infection.