Pulmonary thromboembolism in hospitalised COVID-19 patients at moderate to high risk by Wells score: a report from Lombardy, Italy.
Identifieur interne : 000894 ( Main/Corpus ); précédent : 000893; suivant : 000895Pulmonary thromboembolism in hospitalised COVID-19 patients at moderate to high risk by Wells score: a report from Lombardy, Italy.
Auteurs : Lorenzo Monfardini ; Mauro Morassi ; Paolo Botti ; Roberto Stellini ; Luca Bettari ; Stefania Pezzotti ; Marco Alì ; Cristian Giuseppe Monaco ; Veronica Magni ; Andrea Cozzi ; Simone Schiaffino ; Claudio BnàSource :
- The British journal of radiology [ 1748-880X ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Betacoronavirus (MeSH), Comorbidity (MeSH), Computed Tomography Angiography (methods), Coronavirus Infections (epidemiology), Female (MeSH), Hospitalization (MeSH), Humans (MeSH), Inpatients (statistics & numerical data), Italy (epidemiology), Lung (diagnostic imaging), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (epidemiology), Pulmonary Embolism (epidemiology), Retrospective Studies (MeSH), Risk (MeSH).
- MESH :
- geographic , epidemiology : Italy.
- diagnostic imaging : Lung.
- epidemiology : Coronavirus Infections, Pneumonia, Viral, Pulmonary Embolism.
- methods : Computed Tomography Angiography.
- statistics & numerical data : Inpatients.
- Aged, Betacoronavirus, Comorbidity, Female, Hospitalization, Humans, Male, Middle Aged, Pandemics, Retrospective Studies, Risk.
Abstract
OBJECTIVES
To present a single-centre experience on CT pulmonary angiography (CTPA) for the assessment of hospitalised COVID-19 patients with moderate-to-high risk of pulmonary thromboembolism (PTE).
METHODS
We analysed consecutive COVID-19 patients (RT-PCR confirmed) undergoing CTPA in March 2020 for PTE clinical suspicion. Clinical data were retrieved. Two experienced radiologists reviewed CTPAs to assess pulmonary parenchyma and vascular findings.
RESULTS
Among 34 patients who underwent CTPA, 26 had PTE (76%, 20 males, median age 61 years, interquartile range 54-70), 20/26 (77%) with comorbidities (mainly hypertension, 44%), and 8 (31%) subsequently dying. Eight PTE patients were under thromboprophylaxis with low-molecular-weight heparin, four PTE patients had lower-limbs deep vein thrombosis at ultrasound examination (performed in 33/34 patients). Bilateral PTE characterised 19/26 cases, with main branches involved in 10/26 cases. Twelve patients had a parenchymal involvement >75%, the predominant pneumonia pattern being consolidation in 10/26 patients, ground glass opacities in 9/26, crazy paving in 5/26, and both ground glass opacities and consolidation in 2/26.
CONCLUSION
COVID-19 patients are prone to PTE.
ADVANCES IN KNOWLEDGE
PTE, potentially attributable to an underlying thrombophilic status, may be more frequent than expected in COVID-19 patients. Extension of prophylaxis and adaptation of diagnostic criteria should be considered.
DOI: 10.1259/bjr.20200407
PubMed: 32735448
PubMed Central: PMC7465860
Links to Exploration step
pubmed:32735448Le document en format XML
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<author><name sortKey="Monaco, Cristian Giuseppe" sort="Monaco, Cristian Giuseppe" uniqKey="Monaco C" first="Cristian Giuseppe" last="Monaco">Cristian Giuseppe Monaco</name>
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<author><name sortKey="Bna, Claudio" sort="Bna, Claudio" uniqKey="Bna C" first="Claudio" last="Bnà">Claudio Bnà</name>
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<term>Betacoronavirus (MeSH)</term>
<term>Comorbidity (MeSH)</term>
<term>Computed Tomography Angiography (methods)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Female (MeSH)</term>
<term>Hospitalization (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Inpatients (statistics & numerical data)</term>
<term>Italy (epidemiology)</term>
<term>Lung (diagnostic imaging)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Pulmonary Embolism (epidemiology)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Risk (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Italy</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lung</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
<term>Pulmonary Embolism</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Computed Tomography Angiography</term>
</keywords>
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<term>Hospitalization</term>
<term>Humans</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b>
</p>
<p>To present a single-centre experience on CT pulmonary angiography (CTPA) for the assessment of hospitalised COVID-19 patients with moderate-to-high risk of pulmonary thromboembolism (PTE).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>We analysed consecutive COVID-19 patients (RT-PCR confirmed) undergoing CTPA in March 2020 for PTE clinical suspicion. Clinical data were retrieved. Two experienced radiologists reviewed CTPAs to assess pulmonary parenchyma and vascular findings.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Among 34 patients who underwent CTPA, 26 had PTE (76%, 20 males, median age 61 years, interquartile range 54-70), 20/26 (77%) with comorbidities (mainly hypertension, 44%), and 8 (31%) subsequently dying. Eight PTE patients were under thromboprophylaxis with low-molecular-weight heparin, four PTE patients had lower-limbs deep vein thrombosis at ultrasound examination (performed in 33/34 patients). Bilateral PTE characterised 19/26 cases, with main branches involved in 10/26 cases. Twelve patients had a parenchymal involvement >75%, the predominant pneumonia pattern being consolidation in 10/26 patients, ground glass opacities in 9/26, crazy paving in 5/26, and both ground glass opacities and consolidation in 2/26.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>COVID-19 patients are prone to PTE.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>ADVANCES IN KNOWLEDGE</b>
</p>
<p>PTE, potentially attributable to an underlying thrombophilic status, may be more frequent than expected in COVID-19 patients. Extension of prophylaxis and adaptation of diagnostic criteria should be considered.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32735448</PMID>
<DateCompleted><Year>2020</Year>
<Month>09</Month>
<Day>01</Day>
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<DateRevised><Year>2020</Year>
<Month>09</Month>
<Day>13</Day>
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<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1748-880X</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>93</Volume>
<Issue>1113</Issue>
<PubDate><Year>2020</Year>
<Month>Sep</Month>
<Day>01</Day>
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<Title>The British journal of radiology</Title>
<ISOAbbreviation>Br J Radiol</ISOAbbreviation>
</Journal>
<ArticleTitle>Pulmonary thromboembolism in hospitalised COVID-19 patients at moderate to high risk by Wells score: a report from Lombardy, Italy.</ArticleTitle>
<Pagination><MedlinePgn>20200407</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1259/bjr.20200407</ELocationID>
<Abstract><AbstractText Label="OBJECTIVES" NlmCategory="UNASSIGNED">To present a single-centre experience on CT pulmonary angiography (CTPA) for the assessment of hospitalised COVID-19 patients with moderate-to-high risk of pulmonary thromboembolism (PTE).</AbstractText>
<AbstractText Label="METHODS" NlmCategory="UNASSIGNED">We analysed consecutive COVID-19 patients (RT-PCR confirmed) undergoing CTPA in March 2020 for PTE clinical suspicion. Clinical data were retrieved. Two experienced radiologists reviewed CTPAs to assess pulmonary parenchyma and vascular findings.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="UNASSIGNED">Among 34 patients who underwent CTPA, 26 had PTE (76%, 20 males, median age 61 years, interquartile range 54-70), 20/26 (77%) with comorbidities (mainly hypertension, 44%), and 8 (31%) subsequently dying. Eight PTE patients were under thromboprophylaxis with low-molecular-weight heparin, four PTE patients had lower-limbs deep vein thrombosis at ultrasound examination (performed in 33/34 patients). Bilateral PTE characterised 19/26 cases, with main branches involved in 10/26 cases. Twelve patients had a parenchymal involvement >75%, the predominant pneumonia pattern being consolidation in 10/26 patients, ground glass opacities in 9/26, crazy paving in 5/26, and both ground glass opacities and consolidation in 2/26.</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="UNASSIGNED">COVID-19 patients are prone to PTE.</AbstractText>
<AbstractText Label="ADVANCES IN KNOWLEDGE" NlmCategory="UNASSIGNED">PTE, potentially attributable to an underlying thrombophilic status, may be more frequent than expected in COVID-19 patients. Extension of prophylaxis and adaptation of diagnostic criteria should be considered.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Monfardini</LastName>
<ForeName>Lorenzo</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, Brescia, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Morassi</LastName>
<ForeName>Mauro</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, Brescia, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Botti</LastName>
<ForeName>Paolo</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, Brescia, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Stellini</LastName>
<ForeName>Roberto</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Infectious Diseases Service, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, Brescia, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bettari</LastName>
<ForeName>Luca</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, Brescia, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pezzotti</LastName>
<ForeName>Stefania</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, Brescia, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Alì</LastName>
<ForeName>Marco</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, San Donato Milanese, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Unit of Diagnostic Imaging and Stereotactic Radiosurgery, C.D.I. Centro Diagnostico Italiano S.p.A., Via Simone Saint Bon 20, Milano, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Monaco</LastName>
<ForeName>Cristian Giuseppe</ForeName>
<Initials>CG</Initials>
<AffiliationInfo><Affiliation>Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, San Donato Milanese, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Magni</LastName>
<ForeName>Veronica</ForeName>
<Initials>V</Initials>
<AffiliationInfo><Affiliation>Medical School, Università degli Studi di Milano, Via Festa del Perdono 7, Milano, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cozzi</LastName>
<ForeName>Andrea</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, Milano, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Schiaffino</LastName>
<ForeName>Simone</ForeName>
<Initials>S</Initials>
<Identifier Source="ORCID">http://orcid.org/0000-0003-4243-888X</Identifier>
<AffiliationInfo><Affiliation>Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, San Donato Milanese, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bnà</LastName>
<ForeName>Claudio</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, Brescia, Italy.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D064888">Observational Study</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>07</Month>
<Day>31</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>Br J Radiol</MedlineTA>
<NlmUniqueID>0373125</NlmUniqueID>
<ISSNLinking>0007-1285</ISSNLinking>
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<CitationSubset>AIM</CitationSubset>
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<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
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<MeshHeading><DescriptorName UI="D007558" MajorTopicYN="N" Type="Geographic">Italy</DescriptorName>
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