Prevalence of Pulmonary Embolism in Emergency Department Patients With Suspected COVID‐19: The Truth Remains Unknown

Ehrman, Robert R.; Collins, Jonathan; Harrison, Nick

doi:10.1111/acem.14137

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…Emerging evidence suggests that COVID‐19 can be complicated by acute pulmonary embolism (APE), 5–7 and d ‐dimer values have been linked to a higher risk of death in patients with COVID‐19 8 …”

Section: Introductionmentioning

confidence: 99%

“…3 The severity of COVID-19 cases has been classified as mild, moderate, severe, and critical. 4 Emerging evidence suggests that COVID-19 can be complicated by acute pulmonary embolism (APE), [5][6][7] and D-dimer values have been linked to a higher risk of death in patients with COVID-19. 8 Although data from different studies indicate that the incidence of venous thromboembolism (VTE) in COVID-19 patients is higher than figures seen in similarly ill hospitalised non-COVID-19 subjects, the exact prevalence of APE in COVID-19 patients is not known, and the diagnostic value of D-dimer in subjects with acute SARS-CoV-2 infection is not clear.…”

Section: Introductionmentioning

confidence: 99%

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Acute pulmonary embolism in patients presenting pulmonary deterioration after hospitalisation for non‐critical COVID‐19

Friz

Gelfi

Orenti

et al. 2021

Internal Medicine Journal

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Background Emerging evidence suggests an association between COVID‐19 and acute pulmonary embolism (APE). Aims To assess the prevalence of APE in patients hospitalised for non‐critical COVID‐19 who presented clinical deterioration, and to investigate the association of clinical and biochemical variables with a confirmed diagnosis of APE in these subjects. Methods All consecutive patients admitted to the internal medicine department of a general hospital with a diagnosis of non‐critical COVID‐19, who performed a computer tomography pulmonary angiography (CTPA) for respiratory deterioration in April 2020, were included in this retrospective cohort study. Results Study populations: 41 subjects, median (interquartile range) age: 71.7 (63–76) years, CPTA confirmed APE = 8 (19.51%, 95% confidence interval (CI): 8.82–34.87%). Among patients with and without APE, no significant differences were found with regards symptoms, comorbidities, treatment, Wells score and outcomes. The optimal cut‐off value of d‐dimer for predicting APE was 2454 ng/mL, sensitivity (95% CI): 63 (24–91), specificity: 73 (54–87), positive predictive value: 36 (13–65), negative predictive value: 89 (71–98) and AUC: 0.62 (0.38–0.85). The standard and age‐adjusted d‐dimer cut‐offs, and the Wells score ≥2 did not associate with confirmed APE, albeit a cut‐off value of d‐dimer = 2454 ng/mL showed an relative risk: 3.21; 95% CI: 0.92–13.97; P = 0.073. Heparin at anticoagulant doses was used in 70.73% of patients before performing CTPA. Conclusion Among patients presenting pulmonary deterioration after hospitalisation for non‐critical COVID‐19, the prevalence of APE is high. Traditional diagnostic tools to identify high APE pre‐test probability patients do not seem to be clinically useful. These results support the use of a high index of suspicion for performing CTPA to exclude or confirm APE as the most appropriate diagnostic approach in this clinical setting.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute pulmonary embolism in patients presenting pulmonary deterioration after hospitalisation for non‐critical COVID‐19

Friz

Gelfi

Orenti

et al. 2021

Internal Medicine Journal

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“…We thank Ehrman et al for their interest and comments on our paper “Association Between Pulmonary Embolism and COVID‐19 in Emergency Department Patients: The PEPCOV International Retrospective Study.” 1,2 The authors raised the important issue of a possible bias, because we only analyzed patients that were tested for pulmonary embolism (PE) with computed tomography pulmonary angiogram. We acknowledge that this is a limitation and accordingly highlighted in our article that whether these results apply to the general population is unknown.…”

mentioning

confidence: 99%

Re: Prevalence of Pulmonary Embolism in ED patients with Suspected COVID‐19: The Truth Remains Unknown

Freund

Drogrey

Cachanado

et al. 2020

Academic Emergency Medicine

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We thank « John Doe » et al. for their interest and comments on our paper “Association between Pulmonary Embolism and COVID‐19 in ED patients: the PEPCOV international retrospective study”. The authors raised the important issue of a possible bias, because we only analyzed patients that were tested for pulmonary embolism (PE) with computed tomography pulmonary angiogram (CTPA). We acknowledge that this is a limitation, and accordingly highlighted in our manuscript that whether these results apply to the general population is unknown.

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Prevalence of Pulmonary Embolism in Emergency Department Patients With Suspected COVID‐19: The Truth Remains Unknown

Cited by 2 publications

References 16 publications

Acute pulmonary embolism in patients presenting pulmonary deterioration after hospitalisation for non‐critical COVID‐19

Acute pulmonary embolism in patients presenting pulmonary deterioration after hospitalisation for non‐critical COVID‐19

Re: Prevalence of Pulmonary Embolism in ED patients with Suspected COVID‐19: The Truth Remains Unknown

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