Melazzini Federica, Reduzzi Margherita, Quaglini Silvana, Fumoso Federica, Lenti Marco Vincenzo, Di Sabatino Antonio
Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
Department of Electrical, Computer, and Biomedical Engineering, University of Pavia, Pavia, Italy.
Front Med (Lausanne). 2021 Apr 30;8:637375. doi: 10.3389/fmed.2021.637375. eCollection 2021.
Pulmonary embolism (PE) is a frequent, life-threatening COVID-19 complication, whose diagnosis can be challenging because of its non-specific symptoms. There are no studies assessing the impact of diagnostic delay on COVID-19 related PE. The aim of our exploratory study was to assess the diagnostic delay of PE in COVID-19 patients, and to identify potential associations between patient- or physician-related variables and the delay. This is a single-center observational retrospective study that included 29 consecutive COVID-19 patients admitted to the San Matteo Hospital Foundation between February and May 2020, with a diagnosis of PE, and a control population of 23 non-COVID-19 patients admitted at our hospital during the same time lapse in 2019. We calculated the patient-related delay (i.e., the time between the onset of the symptoms and the first medical examination), and the physician-related delay (i.e., the time between the first medical examination and the diagnosis of PE). The overall diagnostic delay significantly correlated with the physician-related delay ( < 0.0001), with the tendency to a worse outcome in long physician-related diagnostic delay ( = 0.04). The delay was related to the presence of fever, respiratory symptoms and high levels of lactate dehydrogenase. It is important to rule out PE as soon as possible, in order to start the right therapy, to improve patient's outcome and to shorten the hospitalization.
肺栓塞（PE）是一种常见的、危及生命的COVID-19并发症，由于其症状不具特异性，其诊断可能具有挑战性。目前尚无研究评估诊断延迟对COVID-19相关PE的影响。我们的探索性研究旨在评估COVID-19患者中PE的诊断延迟情况，并确定患者或医生相关变量与延迟之间的潜在关联。这是一项单中心观察性回顾性研究，纳入了2020年2月至5月期间连续收治于圣马泰奥医院基金会的29例确诊为PE的COVID-19患者，以及2019年同期在我院收治的23例非COVID-19患者作为对照人群。我们计算了患者相关延迟（即症状出现至首次医学检查的时间）和医生相关延迟（即首次医学检查至PE诊断的时间）。总体诊断延迟与医生相关延迟显著相关（<0.0001），医生相关诊断延迟时间长时预后有变差的趋势（=0.04）。延迟与发热、呼吸道症状及高乳酸脱氢酶水平有关。尽快排除PE很重要，以便开始正确的治疗，改善患者预后并缩短住院时间。
