The prevalence of pulmonary embolism in patients with COVID-19 and respiratory decline: A three-setting comparison.
The prevalence of pulmonary embolism in patients with COVID-19 and respiratory decline: A three-setting comparison.
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DOI：
10.1016/j.thromres.2020.10.012
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发表时间：
2020-12
影响因子：
7.5
通讯作者：
Ten Cate H
中科院分区：
文献类型：
--
作者：
Brüggemann RAG;Spaetgens B;Gietema HA;Brouns SHA;Stassen PM;Magdelijns FJ;Rennenberg RJ;Henry RMA;Mulder MMG;van Bussel BCT;Schnabel RM;van der Horst ICC;Wildberger JE;Stehouwer CDA;Ten Cate H
2019冠状病毒病（COVID-19）患者的肺栓塞（PE）风险已得到认可。在急诊科（艾德）、普通病房和重症监护室（ICU）呼吸恶化患者中PE的患病率尚不明确。我们的目的是调查在不同环境下，COVID-19和呼吸恶化个体中PE的发生频率，以及通过CT严重程度评分（CTSS）测量的疾病严重程度是否与PE的发生有关。在4月6日至5月3日期间，我们从艾德、普通病房和ICU连续招募了60名符合预先规定的呼吸恶化标准的确诊COVID-19成人患者。共有24（24/60：40%（95% CI：28-54%））患者被诊断为PE，其中6例在艾德治疗（6/23：26%（95% CI：10-46%）），8例在普通病房（8/24：33%（95% CI：16-55%）），10例在ICU（10/13：77%（95% CI：46-95%））。CTSS（每单位）与PE的发生无关（年龄和性别调整OR 1.06（95%CI 0.98-1.15））。COVID-19和呼吸恶化患者的PE诊断数量较高;艾德、普通病房和ICU分别为26%、33%和77%。在我们的队列中，CTSS与PE的发生无关。基于扫描患者中诊断为PE的患者数量较多，我们建议对COVID-19和呼吸恶化患者进行计算机断层扫描血管造影的阈值较低。COVID-19肺栓塞的高患病率不仅限于ICU COVID-19患者的呼吸恶化应提示低阈值CTPA常规血栓预防可能不足以预防COVID-19患者的PE
The risk of pulmonary embolism (PE) in patients with Coronavirus Disease 2019 (COVID-19) is recognized. The prevalence of PE in patients with respiratory deterioration at the Emergency Department (ED), the regular ward, and the Intensive Care Unit (ICU) are not well-established. We aimed to investigate how often PE was present in individuals with COVID-19 and respiratory deterioration in different settings, and whether or not disease severity as measured by CT-severity score (CTSS) was related to the occurrence of PE. Between April 6th and May 3rd, we enrolled 60 consecutive adult patients with confirmed COVID-19 from the ED, regular ward and ICU who met the pre-specified criteria for respiratory deterioration. A total of 24 (24/60: 40% (95% CI: 28–54%)) patients were diagnosed with PE, of whom 6 were in the ED (6/23: 26% (95% CI: 10–46%)), 8 in the regular ward (8/24: 33% (95% CI: 16–55%)), and 10 in the ICU (10/13: 77% (95% CI: 46–95%)). CTSS (per unit) was not associated with the occurrence of PE (age and sex-adjusted OR 1.06 (95%CI 0.98–1.15)). The number of PE diagnosis among patients with COVID-19 and respiratory deterioration was high; 26% in the ED, 33% in the regular ward and 77% in the ICU respectively. In our cohort CTSS was not associated with the occurrence of PE. Based on the high number of patients diagnosed with PE among those scanned we recommend a low threshold for performing computed tomography angiography in patients with COVID-19 and respiratory deterioration. The high prevalence of pulmonary embolism in COVID-19 is not limited to the ICU Respiratory deterioration in COVID-19 patients should prompt a low threshold CTPA Regular thromboprophylaxis may be insufficient to prevent PE in COVID-19 patients
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影响因子：
2.9
作者：
Tas J;van Gassel RJJ;Heines SJH;Mulder MMG;Heijnen NFL;Acampo-de Jong MJ;Bels JLM;Bennis FC;Koelmann M;Groven RVM;Donkers MA;van Rosmalen F;Hermans BJM;Meex SJ;Mingels A;Bekers O;Savelkoul P;Oude Lashof AML;Wildberger J;Tijssen FH;Buhre W;Sels JEM;Ghossein-Doha C;Driessen RGH;Kubben PL;Janssen MLF;Nicolaes GAF;Strauch U;Geyik Z;Delnoij TSR;Walraven KHM;Stehouwer CD;Verbunt JAMCF;Van Mook WNKA;van Santen S;Schnabel RM;Aries MJH;van de Poll MCG;Bergmans D;van der Horst ICC;van Kuijk S;van Bussel BCT
通讯作者：
van Bussel BCT
影响因子：
7.5
作者：
van Dam, L. F.;Kroft, L. J. M.;Klok, F. A.
通讯作者：
Klok, F. A.
影响因子：
158.5
作者：
Ackermann, Maximilian;Verleden, Stijn E.;Jonigk, Danny
通讯作者：
Jonigk, Danny
影响因子：
2.9
作者：
van Maanen, Rosanne;Rutten, Frans H.;Geersing, Geert-Jan
通讯作者：
Geersing, Geert-Jan
影响因子：
10.4
作者：
Middeldorp, Saskia;Coppens, Michiel;van Es, Nick
通讯作者：
van Es, Nick