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住院COVID-19患者中肺栓塞的发病率及转归

Incidence and Outcomes of Pulmonary Embolism among Hospitalized COVID-19 Patients.

作者信息

Badr Omaima Ibrahim, Alwafi Hassan, Elrefaey Wael Aly, Naser Abdallah Y, Shabrawishi Mohammed, Alsairafi Zahra, Alsaleh Fatemah M

机构信息

Department of Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt.

Department of Pulmonary Medicine, Al Noor Specialist Hospital, Mecca 20424, Saudi Arabia.

出版信息

Int J Environ Res Public Health. 2021 Jul 18;18(14):7645. doi: 10.3390/ijerph18147645.

Abstract

OBJECTIVES

Patients with COVID-19 may be at high risk for thrombotic complications due to excess inflammatory response and stasis of blood flow. This study aims to assess the incidence of pulmonary embolism among hospitalized patients with COVID-19, risk factors, and the impact on survival.

METHODS

A retrospective case-control study was conducted at Al-Noor Specialist Hospital in Saudi Arabia between 15 March 2020 and 15 June 2020. Patients with confirmed COVID-19 diagnosis by a real-time polymerase chain reaction (PCR) and confirmed diagnosis of pulmonary embolism by Computed Tomography pulmonary angiogram (CTPA) formed the case group. Patients with confirmed COVID-19 diagnosis by a real-time polymerase chain reaction (PCR) and without confirmed diagnose of pulmonary embolism formed the control group. Logistic regression analysis was used to identify predictors of pulmonary embolism and survival.

RESULTS

A total of 159 patients participated were included in the study, of which 51 were the cases (patients with pulmonary embolism) and 108 patients formed the control group (patients without pulmonary embolism). The incidence of PE among those hospitalized was around 32%. Smoking history, low level of oxygen saturation, and higher D-dimer values were important risk factors that were associated with a higher risk of developing PE ( < 0.05). Higher respiratory rate was associated with higher odds of death, and decreased the possibility of survival among hospitalized patients with PE.

CONCLUSIONS

Pulmonary embolism is common among hospitalized patients with COVID-19. Preventive measures should be considered for hospitalized patients with smoking history, low level of oxygen saturation, high D-dimer values, and high respiratory rate.

摘要

目的

由于炎症反应过度和血流淤滞,新冠肺炎患者可能面临血栓形成并发症的高风险。本研究旨在评估新冠肺炎住院患者中肺栓塞的发生率、危险因素及其对生存的影响。

方法

2020年3月15日至2020年6月15日在沙特阿拉伯的努尔专科医院进行了一项回顾性病例对照研究。通过实时聚合酶链反应(PCR)确诊为新冠肺炎且通过计算机断层扫描肺动脉造影(CTPA)确诊为肺栓塞的患者组成病例组。通过实时聚合酶链反应(PCR)确诊为新冠肺炎但未确诊为肺栓塞的患者组成对照组。采用逻辑回归分析来确定肺栓塞和生存的预测因素。

结果

共有159名参与研究的患者,其中51例为病例组(肺栓塞患者),108例患者组成对照组(无肺栓塞患者)。住院患者中肺栓塞的发生率约为32%。吸烟史、低氧饱和度水平和较高的D-二聚体值是与发生肺栓塞风险较高相关的重要危险因素(<0.05)。较高的呼吸频率与较高的死亡几率相关,并降低了新冠肺炎住院合并肺栓塞患者的生存可能性。

结论

肺栓塞在新冠肺炎住院患者中很常见。对于有吸烟史、低氧饱和度水平、高D-二聚体值和高呼吸频率的住院患者,应考虑采取预防措施。

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