Division of Pulmonary, Critical Care and Sleep Medicine, New York University Langone Health, New York, NY, USA.
Leon H. Charney Division of Cardiology, New York University Langone Health, New York, NY, USA.
J Thromb Thrombolysis. 2021 Feb;51(2):330-338. doi: 10.1007/s11239-020-02264-8.
Coronavirus disease 2019 (COVID-19) is associated with increased rates of deep vein thrombosis (DVT) and pulmonary embolism (PE). Pulmonary Embolism Response Teams (PERT) have previously been associated with improved outcomes. We aimed to investigate whether PERT utilization, recommendations, and outcomes for patients diagnosed with acute PE changed during the COVID-19 pandemic. This is a retrospective cohort study of all adult patients with acute PE who received care at an academic hospital system in New York City between March 1st and April 30th, 2020. These patients were compared against historic controls between March 1st and April 30th, 2019. PE severity, PERT utilization, initial management, PERT recommendations, and outcomes were compared. There were more cases of PE during the pandemic (82 vs. 59), but less PERT activations (26.8% vs. 64.4%, p < 0.001) despite similar markers of PE severity. PERT recommendations were similar before and during the pandemic; anticoagulation was most recommended (89.5% vs. 86.4%, p = 0.70). During the pandemic, those with PERT activations were more likely to be female (63.6% vs. 31.7%, p = 0.01), have a history of DVT/PE (22.7% vs. 1.7%, p = 0.01), and to be SARS-CoV-2 PCR negative (68.2% vs. 38.3% p = 0.02). PERT activation during the pandemic is associated with decreased length of stay (7.7 ± 7.7 vs. 13.2 ± 12.7 days, p = 0.02). PERT utilization decreased during the COVID-19 pandemic and its activation was associated with different biases. PERT recommendations and outcomes were similar before and during the pandemic, and led to decreased length of stay during the pandemic.
新型冠状病毒病 2019（COVID-19）与深静脉血栓形成（DVT）和肺栓塞（PE）的发生率增加有关。肺栓塞反应团队（PERT）以前与改善结果有关。我们旨在研究 COVID-19 大流行期间，诊断为急性 PE 的患者的 PERT 利用率、建议和结果是否发生变化。这是一项回顾性队列研究，纳入了 2020 年 3 月 1 日至 4 月 30 日期间在纽约市一家学术医院系统接受治疗的所有成年急性 PE 患者。将这些患者与 2019 年 3 月 1 日至 4 月 30 日的历史对照进行比较。比较了 PE 严重程度、PERT 利用率、初始治疗、PERT 建议和结局。大流行期间 PE 病例较多（82 例比 59 例），但 PERT 激活较少（26.8%比 64.4%，p<0.001），尽管 PE 严重程度的标志物相似。大流行前后 PERT 建议相似；最推荐抗凝治疗（89.5%比 86.4%，p=0.70）。在大流行期间，接受 PERT 激活的患者更可能为女性（63.6%比 31.7%，p=0.01）、有 DVT/PE 病史（22.7%比 1.7%，p=0.01），并且 SARS-CoV-2 PCR 阴性（68.2%比 38.3%，p=0.02）。大流行期间 PERT 激活与住院时间缩短相关（7.7±7.7 比 13.2±12.7 天，p=0.02）。COVID-19 大流行期间 PERT 利用率下降，其激活与不同的偏倚有关。大流行前后 PERT 建议和结果相似，大流行期间导致住院时间缩短。
