Aims While pulmonary embolism (PE) appears to be a major issue in COVID-19, data remain sparse. We aimed to describe the risk factors and baseline characteristics of patients with PE in a cohort of COVID-19 patients. Methods and results In a retrospective multicentre observational study, we included consecutive patients hospitalized for COVID-19. Patients without computed tomography pulmonary angiography (CTPA)-proven PE diagnosis and those who were directly admitted to an intensive care unit (ICU) were excluded. Among 1240 patients (58.1% men, mean age 64 ± 17 years), 103 (8.3%) patients had PE confirmed by CTPA. The ICU transfer and mechanical ventilation were significantly higher in the PE group (for both P < 0.001). In an univariable analysis, traditional venous thrombo-embolic risk factors were not associated with PE (P > 0.05), while patients under therapeutic dose anticoagulation before hospitalization or prophylactic dose anticoagulation introduced during hospitalization had lower PE occurrence [odds ratio (OR) 0.40, 95% confidence interval (CI) 0.14–0.91, P = 0.04; and OR 0.11, 95% CI 0.06–0.18, P < 0.001, respectively]. In a multivariable analysis, the following variables, also statistically significant in univariable analysis, were associated with PE: male gender (OR 1.03, 95% CI 1.003–1.069, P = 0.04), anticoagulation with a prophylactic dose (OR 0.83, 95% CI 0.79–0.85, P < 0.001) or a therapeutic dose (OR 0.87, 95% CI 0.82–0.92, P < 0.001), C-reactive protein (OR 1.03, 95% CI 1.01–1.04, P = 0.001), and time from symptom onset to hospitalization (OR 1.02, 95% CI 1.006–1.038, P = 0.002). Conclusion PE risk factors in the COVID-19 context do not include traditional thrombo-embolic risk factors but rather independent clinical and biological findings at admission, including a major contribution to inflammation.

Higher rates of severe COVID‐19 have been reported in kidney transplant recipients (KTRs) compared to non‐transplant patients. We aimed to determine if poorer outcomes were specifically related to chronic immunosuppression or underlying comorbidities. We used a 1:1 propensity score‐matching method to compare survival and severe disease‐free survival (defined as death and/or need for intensive care unit (ICU)) incidence in hospitalized KTRs and non‐transplant control patients between 26 February and 22 May 2020. Patients were matched for risk factors of severe COVID‐19: age, sex, body mass index, diabetes mellitus, preexisting cardiopathy, chronic lung disease and basal renal function. We included 100 KTRs (median age [interquartile range (IQR)]) 64.7 years (55.3‐73.1) in 3 French transplant centers. After a median follow‐up of 13 days (7‐30), transfer to ICU was required for 34 patients (34%) and death occurred in 26 patients (26%). Overall, 43 patients (43%) developed a severe disease during a median follow‐up of 8.5 days (2‐14). Propensity score matching to a large French cohort of 2017 patients hospitalized in 24 centers, revealed that survival was similar between KTRs and matched non‐transplant patients with respective 30‐days survival of 62.9% and 71% (p=0.38) and severe disease‐free 30‐days survival of 50.6% and 47.5% (p=0.91). These findings suggest that severity of COVID‐19 in KTRs is related to their associated comorbidities and not to chronic immunosuppression.

Background COVID‐19 is a respiratory disease associated to thrombotic outcomes with coagulation and endothelial disorders. Based on that, several anticoagulation (AC) guidelines have been proposed. We aimed to identify if AC therapy modifies the risk of developing severe COVID‐19. Methods and Results COVID‐19 patients initially admitted in medical wards of 24 French hospitals were included prospectively from February 26th to April 20th, 2020. We used Poisson regression model, Cox proportional hazard model and matched propensity score to assess the effect of AC on outcomes (intensive care unit (ICU) admission and/or in‐hospital mortality). Study enrolled 2878 COVID‐19 patients, among whom 382 (13.2%) were treated with oral AC therapy prior to hospitalization. After adjustment, AC therapy prior to hospitalization was associated with a better prognosis with an adjusted Hazard Ratio (aHR) 0.70 (95% CI 0.55‐0.88). Analyses performed using propensity score matching confirmed that AC therapy prior to hospitalization was associated with a better prognosis with an aHR of 0.43 (95% CI 0.29–0.63) for ICU admission and aHR of 0.76 (95% CI 0.61–0.98) for composite criteria ICU admission and/or death. In contrast, therapeutic or prophylactic low or high dose AC started during hospitalization were not associated with any of the outcomes. Conclusions AC therapy used prior to hospitalization in medical wards was associated with a better prognosis in contrast to AC initiated during hospitalization. AC therapy introduced in early step of disease could better prevent COVID‐19‐associated coagulopathy, endotheliopathy and prognosis.

One crucial parameter to evaluate the state of the heart after myocardial infarction (MI) is the viability of the myocardial segment, i.e., if the segment recovers its functionality upon revascularization. MRI performed several minutes after the injection of a contrast agent (delayed enhancement-MRI or DE-MRI) is a method of choice to evaluate the extent of MI, and by extension, to assess viable tissues after an injury. The Emidec dataset is composed of a series of exams with DE-MR images in short axis orientation covering the left ventricle from normal cases or patients with myocardial infarction, with the contouring of the myocardium and diseased areas (if present) from experts in the domains. Moreover, classical available clinical parameters when the patient is managed by an emergency department are provided for each case. To the best of our knowledge, the Emidec dataset is the first one where annotated DE-MRI are combined with clinical characteristics of the patient, allowing the development of methodologies for exam classification as for exam quantification.

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to a public health crisis. Only limited data are available on the characteristics and outcomes of patients hospitalized for COVID-19 in France. Aims: To investigate the characteristics, cardiovascular complications and outcomes of patients hospitalized for COVID-19 in France. Methods: The Critical COVID-19 France (CCF) study is a French nationwide study including all consecutive adults with a diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection hospitalized in 24 centres between 26 February and 20 April 2020. Patients admitted directly to intensive care were excluded. Clinical, biological and imaging parameters were systematically collected at hospital admission. The primary outcome was in-hospital death. Results: Of 2878 patients included (mean ± SD age 66.6 ± 17.0 years, 57.8% men), 360 (12.5%) died in the hospital setting, of which 7 (20.7%) were transferred to intensive care before death. The majority of patients had at least one (72.6%) or two (41.6%) cardiovascular risk factors, mostly hypertension (50.8%), obesity (30.3%), dyslipidaemia (28.0%) and diabetes (23.7%). In multivariable analysis, older age (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.03−1.06; P < 0.001), male sex (HR 1.69, 95% CI 1.11−2.57; P = 0.01), diabetes (HR 1.72, 95% CI 1.12−2.63; P = 0.01), chronic kidney failure (HR 1.57, 95% CI 1.02−2.41; P = 0.04), elevated troponin (HR 1.66, 95% CI 1.11−2.49; P = 0.01), elevated B-type natriuretic peptide or N-terminal pro-B-type natriuretic peptide (HR 1.69, 95% CI 1.0004−2.86; P = 0.049) and quick Sequential Organ Failure Assessment score ≥ 2 (HR 1.71, 95% CI 1.12−2.60; P = 0.01) were independently associated with in-hospital death. Conclusions: In this large nationwide cohort of patients hospitalized for COVID-19 in France, cardiovascular comorbidities and risk factors were associated with a substantial morbi-mortality burden.