Diagnosis of COVID-19 in Patients with Acute Pulmonary Embolism

Abstract

Acute pulmonary embolism (PE) and Coronavirus disease-2019 (COVID-19) are lifethreatening diseases associated with significant morbidity and mortality. Yet little is known about their co-existence. This study explored clinical and laboratory differences between PE patients who tested positive with real-time reverse-transcription polymerase chain reaction (PCR+) and those who tested negative (PCR-) for SARS-CoV-2. Also, to determine whether ferritin D-dimer ratio (FDR) and platelet D-dimer ratio (PDR) can be used to predict COVID-19 in patients with PE. Files of 556 patients who underwent a computed tomography pulmonary angiography (CTPA) examination were retrospectively investigated. Out of them, 197 tested positive and 188 negatives for SARS-CoV-2. The PCR+ group 113 (57.36 %) and the PCRgroup 113 (60.11 %) had a diagnosis of PE. Complaints, respiratory rate, and oxygen saturation level in the blood (SpO2) were recorded at the first admission. Monocyte and eosinophil levels remained low, whereas FDR and PDR were higher in the PCR+ group. No difference was detected between ferritin, D-dimer levels, comorbidities, SpO2, and death rates. Cough, fever, joint pain, and higher respiratory rate were more common in the PCR+ group. A decrease in WBC, monocyte, and eosinophil levels, whereas an increase in FDR and PDR levels may predict COVID-19 in patients with PE. PE patients complaining of cough, fever, and fatigue should undergo PCR testing as common symptoms. COVID-19 does not seem to increase the risk of mortality in patients with PE.