Pulmonary Embolism Diagnosed by CT Pulmonary Angiography in Patients with COVID-19 and Features of the Associated Factors

Abstract

Background: Since December 2019, when a new coronavirus disease 2019 (COVID-19) was detected in Wuhan, China, over 774 million confirmed COVID-19 cases and over seven million deaths have been reported globally, as of 7 January 2024 (WHO, 2024). Venous thromboembolism is a recognized complication of COVID-19. This study aimed to investigate the prevalence of pulmonary embolism (PE) diagnosed by CT pulmonary angiography (CTPA) in COVID-19 patients and the features of the associated factors. Methods and Results: The study included 162 patients from the Imam Abdulrahman Al-Faisal Hospital who had COVID-19-confirmed infections while hospitalized in the ICU. Patients were diagnosed as COVID-19 positive by RT-PCR and underwent CTPA examination on the Discovery 16-slice CT scanner (Siemens, Germany) following standard protocol. For contrast enhancement, non-ionic, iodinated, intravenous contrast material (Omnipaque 350 mg) was used. PE was detected by CTPA in 87(53.7%) COVID-19 patients. The D-dimer level was significantly higher in the PE group than in the non-PE group. The frequency of renal impairment in the PE group was 2.3 times higher than in the non-PE group. The ICU duration was longer in the PE group than in non-PE group (12.9±11.3 and 8.6±7.2 days, P=0.005). The death rate was 17.2% in the PE group and 1.3% in the non-PE group (P=0.001). The heart and respiratory rates, blood pressure, BMI, BUN, and creatinine levels did not differ in the study groups. The frequency of diabetes, hypertension, asthma, COPD, and smoking were comparable in the groups. Conclusion: CTPA is very important in diagnosing PE in COVID-19 patients. CTPA-diagnosed PE is significantly associated with D-dimer, ICU duration, and death.