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  1. Article ; Online: Acute phase characteristics and long-term complications of pulmonary embolism in COVID-19 compared to non-COVID-19 cohort: a large single-centre study.

    Franco-Moreno, A / Brown-Lavalle, D / Campos-Arenas, M / Rodríguez-Ramírez, N / Muñoz-Roldán, C / Rubio-Aguilera, A I / Muñoz-Rivas, N / de Girón, J Bascuñana-Morejón / Fernández-Vidal, E / Palma-Huerta, E / Estévez-Alonso, S / Rodríguez-Gómez, B / Manzano-Valera, S / Pedrero-Tomé, R / Casado-Suela, M / Bibiano-Guillén, C / Mir-Montero, M / Torres-Macho, J / Bustamante-Fermosel, A

    BMC pulmonary medicine

    2023  Volume 23, Issue 1, Page(s) 25

    Abstract: Background: To compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death are valid in this population.: Methods: ... ...

    Abstract Background: To compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death are valid in this population.
    Methods: We retrospectively included hospitalized patients with PE from 1 January 2016 to 31 December 2022. Comparisons for acute episode characteristics, risk stratification of the PE, outcomes, and long-term complications were made between COVID and non-COVID patients.
    Results: We analyzed 116 (27.5%) COVID patients and 305 (72.4%) non-COVID patients. In patients with COVID-19, the traditional risk factors for PE were absent, and the incidence of deep vein thrombosis was lower. COVID patients showed significantly higher lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels. COVID patients had PE of smaller size (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental and 13.2% vs. 7.9% subsegmental, respectively; p < 0.001), less right ventricular dysfunction (7.7% vs. 17.7%; p = 0.007) and higher sPESI score (1.66 vs. 1.11; p < 0.001). The need for mechanical ventilation was significantly higher in COVID patients (8.6% vs. 1.3%; p < 0.001); However, the in-hospital death was less (5.2% vs. 10.8%; p = 0.074). The incidence of long-term complications was lower in COVID cohort (p < 0.001). PE severity assessed by high sPESI and intermediate and high-risk categories were independently associated with in-hospital mortality in COVID patients.
    Conclusion: The risk of in-hospital mortality and the incidence of long-term complications were lower in COVID-19. The usual tools for risk stratification of PE are valid in COVID patients.
    MeSH term(s) Humans ; Hospital Mortality ; COVID-19/complications ; Retrospective Studies ; Pulmonary Embolism/complications ; Pulmonary Artery ; Risk Assessment
    Language English
    Publishing date 2023-01-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059871-3
    ISSN 1471-2466 ; 1471-2466
    ISSN (online) 1471-2466
    ISSN 1471-2466
    DOI 10.1186/s12890-023-02323-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: External validation of the CHEDDAR score for suspected pulmonary embolism in patients with SARS-CoV-2 infection in an independent cohort.

    Franco-Moreno, Anabel / Palma-Huerta, Elena / Fernández-Vidal, Elisa / Madroñal-Cerezo, Elena / Marco-Martínez, Javier / Romero-Pareja, Rodolfo / Izquierdo-Martínez, Aida / Carpintero-García, Lorena / Ruiz-Giardín, José Manuel / Torres-Macho, Juan / de Ancos-Aracil, Cristina Lucía

    Journal of thrombosis and thrombolysis

    2023  Volume 57, Issue 3, Page(s) 352–357

    Abstract: The accuracy of the classic scores that help stratify the pretest clinical probability of pulmonary embolism (PE) in SARS-CoV-2 infection (COVID-19) is low. Therefore, to estimate the risk of PE in these patients, a new set of guidelines must be ... ...

    Abstract The accuracy of the classic scores that help stratify the pretest clinical probability of pulmonary embolism (PE) in SARS-CoV-2 infection (COVID-19) is low. Therefore, to estimate the risk of PE in these patients, a new set of guidelines must be established. The recently published CHEDDAR score proposes a new diagnostic strategy to reduce the use of computed tomography pulmonary angiography (CTPA) in non-critically ill SARS-COV-2 patients with suspected PE. According to the nomogram, patients are segregated into low-risk (< 182 points) or high-risk (≥ 182 points) based on the best cut-off value to discard PE in the original cohort. We aimed to externally validate this diagnostic strategy in an independent cohort. We analyzed data from two retrospective cohorts of hospitalized non-critically ill COVID-19 patients who underwent a CTPA due to suspicion for PE. CHEDDAR score was applied. As per the CHEDDAR nomogram, patients were classified as having a low or high clinical pre-test probability. Of the 270 patients included, 69 (25.5%) had PE. Applying the CHEDDAR score, 182 (67.4%) patients could have had PE excluded without imaging. Among 58 patients classified as having high clinical pre-test probability, 39 (67.2%) had PE. Sensitivity, specificity, positive and negative predictive values, and AUC were 56%, 90%, 67%, 85%, and 0.783 (95% CI 0.71-0.85), respectively. We provide external validation of the CHEDDAR score in an independent cohort. Even though the CHEDDAR score showed good discrimination capacity, caution is required in patients classified as having low clinical pre-test probability with a D-dimer value > 3000 ng/mL, and a RALE score ≥ 4.
    MeSH term(s) Humans ; COVID-19/complications ; COVID-19/diagnosis ; Retrospective Studies ; Fibrin Fibrinogen Degradation Products ; SARS-CoV-2 ; Pulmonary Embolism/diagnosis
    Chemical Substances Fibrin Fibrinogen Degradation Products
    Language English
    Publishing date 2023-12-14
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1230645-9
    ISSN 1573-742X ; 0929-5305
    ISSN (online) 1573-742X
    ISSN 0929-5305
    DOI 10.1007/s11239-023-02918-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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