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在医院急诊部门诊断为肺血栓栓塞症和 COVID-19 的患者的临床发现、风险因素和最终结局。

Clinical findings, risk factors, and final outcome in patients diagnosed with pulmonary thromboembolism and COVID-19 in hospital emergency departments.

机构信息

Area de Urgencias, Hospital Clínic. Grupo UPyP, Área 1, IDIBAPS, Barcelona, España.

Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España.

出版信息

Emergencias. 2020;32(4):253-257.

Abstract

OBJECTIVES

To analyze clinical, laboratory, and radiologic findings and final health outcomes in patients with pulmonary embolism and coronavirus disease 2019 (COVID-19). To compare them to findings and outcomes in patients with pulmonary embolism without COVID-19.

MATERIAL AND METHODS

Multicenter, observational, retrospective study in 4 Spanish hospital emergency departments (EDs) from January 15 to April 15, 2020. Cases were located by reviewing all ED requests for pulmonary computed tomography angiography (CTA) procedures. Clinical, laboratory, and radiologic findings; medical histories and comorbidity; risk factors; and outcomes were compared between the 2 groups of patients (with or without COVID-19).

RESULTS

A total of 399 CTAs were ordered; 88 pulmonary embolisms were diagnosed, 28 of them (32%) in patients with COVID-19. This group had more men, and a history of thromboembolic disease was more common. We found no between-group differences in clinical presentation, laboratory, or radiologic findings; nor were there differences in final outcomes. In-hospital mortality was 7% (2 cases) in patients with COVID-19 and 17% (10 cases) in patients without the virus (odds ratio for death in patients with pulmonary embolism and COVID-19, 0.38; 95% CI, 0.08-1.89).

CONCLUSION

We found no clinically important differences in the clinical, laboratory, or radiologic findings between patients with or without COVID-19 who were treated for pulmonary embolism in our hospital EDs. Final outcomes also did not differ.

摘要

目的

分析肺栓塞和 2019 年冠状病毒病(COVID-19)患者的临床、实验室和影像学表现以及最终健康结局。并将其与无 COVID-19 的肺栓塞患者的发现和结局进行比较。

材料和方法

这是一项在西班牙 4 家医院急诊部进行的多中心、观察性、回顾性研究。通过回顾所有因肺计算机断层血管造影(CTA)检查而要求进行的急诊部检查,定位病例。比较两组患者(有或无 COVID-19)的临床、实验室和影像学表现;病史和合并症;危险因素;以及结局。

结果

共进行了 399 次 CTA 检查;诊断出 88 例肺栓塞,其中 28 例(32%)为 COVID-19 患者。该组患者中男性更多,且血栓栓塞病史更为常见。我们未发现两组患者在临床表现、实验室或影像学表现方面存在差异;最终结局也没有差异。COVID-19 患者的住院死亡率为 7%(2 例),无病毒患者为 17%(10 例)(COVID-19 合并肺栓塞患者死亡的比值比,0.38;95%CI,0.08-1.89)。

结论

我们未发现我院急诊部治疗的肺栓塞患者中,有 COVID-19 与无 COVID-19 的患者在临床、实验室或影像学表现方面存在有临床意义的差异。最终结局也没有差异。

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