A Prospective Study Evaluating Cumulative Incidence and a Specific Prediction Rule in Pulmonary Embolism in COVID-19

Castillejo, Carla Suarez; Toledo-Pons, Núria; Calvo, Néstor; Ramon-Clar, Luisa; Martínez, Joaquín; Mendoza, Sara Hermoso de; Morell-García, Daniel; Bauça, Josep Miquel; Berga, Francisco; Núñez, Belén; Preda, Luminita; Sauleda, Jaume; Castillo, P. Argente Del; Ballesteros, A; Martı́n, Luisa; Llinàs, Ernest Sala; Alonso-Fernández, Alberto

doi:10.3389/fmed.2022.936816

Cited by 11 publications

(36 citation statements)

References 41 publications

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“…Accordingly, it could reasonably be predicted that higher NLR values were also found in COVID- PTE group. 14 This observation was consistent with our bivariate analysis of NLR and PTE incidence; however, regression analysis did not show this significance.…”

Section: Nlr and Plr Predictive Value In Covid-19 Infection And Its P...supporting

confidence: 88%

“…Nevertheless, PTE diagnosis in COVID‐19 is challenging for a variety of reasons. First, PTE and COVID‐19 clinical manifestations may overlap 14 . Second, hospital overcrowding during the resurgence of the COVID‐19 epidemic, costs, and lack of availability in all centers make chest CT angiography (CTA) inaccessible for all patients with probable PTE 15 .…”

Section: Introductionmentioning

confidence: 99%

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Predictive value of hematological indices on incidence and severity of pulmonary embolism in COVID‐19 patients

Radkhah,

Mansouri,

Rahimipour Anaraki

et al. 2023

Immunity Inflam & Disease

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BackgroundPulmonary thromboembolism (PTE) is a common complication of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which raises the COVID‐19 disease's fatality rate from 3% to 45%. Nevertheless, due to fairly indistinguishable clinical symptoms and a lack of validated clinical prediction models, PTE diagnosis in COVID‐19 patients is challenging. This study aims to investigate the applicability of hematological indices to predict PTE incidence and its severity in SARS‐CoV‐2 patients.MethodsA retrospective cohort study was conducted on hospitalized patients with a confirmed diagnosis of SARS‐CoV‐2 infection who underwent CT angiography to assess probable PTE in them. The correlation between complete blood count parameters 1 day before CT angiography and CT angiography outcomes, and simplified pulmonary embolism severity index (s‐PESI) was investigated.ResultsWe discovered that among individuals with a probable PTE, males and those with higher platelet‐to‐lymphocyte (PLR) and neutrophil‐to‐lymphocyte (NLR) ratios had a greater likelihood of PTE incidence (p < .001, .027, and .037, respectively). PLR was a significant and independent predictor of PTE with a p value of .045. Moreover, a higher neutrophil count was associated with a higher s‐PESI score in COVID‐19 patients developing PTE (p: .038).ConclusionsAmong hematological indices, NLR and more precisely PLR are cost‐effective and simply calculable markers that can assist physicians in determining whether or not COVID‐19 patients with clinically probable PTE require CT angiography and the higher neutrophil count can be employed as an indicator of PTE severity in COVID‐19 patients. Further large multicenter and prospective studies are warranted to corroborate these observations.

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Section: Nlr and Plr Predictive Value In Covid-19 Infection And Its P...supporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Predictive value of hematological indices on incidence and severity of pulmonary embolism in COVID‐19 patients

Radkhah,

Mansouri,

Rahimipour Anaraki

et al. 2023

Immunity Inflam & Disease

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“…A strong link between COVID-19 infection and hypercoagulability has been reported in recent literature 18,19 . The exact mechanism of COVID-19–induced hypercoagulability is still unclear, but studies suggest that vascular endothelial injury and proinflammatory cytokines play a significant role and contribute to the high mortality of the disease 20 .…”

Section: Discussionmentioning

confidence: 99%

“…A strong link between COVID-19 infection and hypercoagulability has been reported in recent literature. 18,19 The exact mechanism of COVID-19-induced hypercoagulability is still unclear, but studies suggest that vascular endothelial injury and proinflammatory cytokines play a significant role and contribute to the high mortality of the disease. 20 Autologous breast reconstruction surgery presents an increased risk of thromboembolic events because of local mechanical factors and prolonged relative inactivity during and after surgery.…”

Section: Discussionmentioning

confidence: 99%

Prior COVID-19 Infection Predisposes to Worse Outcomes After Autologous Breast Reconstruction

et al. 2023

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Background Major shifts in health care systems worldwide have occurred because of coronavirus disease 2019 (COVID-19). With nearly half of all Americans now having a history of COVID-19 infection, there is a pressing need to better understand the importance of prior COVID-19 infection as a potential surgical risk factor. The aim of this study was to investigate the impact of a history of prior COVID-19 infection on patient outcomes after autologous breast reconstruction. Methods We performed a retrospective study using the TriNetX research database, which contains deidentified patient records from 58 participating international health care organizations. All patients who underwent autologous breast reconstruction between March 1, 2020, and April 9, 2022, were included and were grouped based on history of a prior COVID-19 infection. Demographic, preoperative risk factors, and 90-day postoperative complication data were compared. Data were analyzed by propensity score–matched analysis on TriNetX. Statistical analyses were performed by Fisher exact, χ2, and Mann-Whitney U tests as appropriate. Significance was set at P values of <0.05. Results Patients with a history of autologous breast reconstruction within our temporal study window (N = 3215) were divided into groups with (n = 281) and without (n = 3603) a prior COVID-19 diagnosis. Nonmatched patients with prior COVID-19 had increased rates of select 90-day postoperative complications, including wound dehiscence, contour deformities, thrombotic events, any surgical site complications, and any complications overall. Use of anticoagulant, antimicrobial, and opioid medications was also found to be higher in those with prior COVID-19. After performing propensity-score matching, each cohort consisted of 281 patients without statistically significant differences between any baseline characteristics. When comparing outcomes between matched cohorts, patients with a history of COVID-19 had increased rates of wound dehiscence (odds ratio [OR], 1.90; P = 0.030), thrombotic events (OR, 2.83; P = 0.0031), and any complications (OR, 1.52; P = 0.037). Conclusions Our results suggest that prior COVID-19 infection is a significant risk factor for adverse outcomes after autologous breast reconstruction. Patients with a history of COVID-19 have 183% higher odds of postoperative thromboembolic events, warranting careful patient selection and postoperative management.

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“…Studies have provided evidence of a close causal association of COVID19 and PE [ 51 ]. The incidence of COVID-19-related PE depends on the clinical setting, the use of thromboprophylaxis and previous history and may be as high as 39.7% [ 52 ]. The elevation of D-dimer levels in the COVID-19 population may stem from prothrombotic coagulopathy or pulmonary microvascular thrombosis [ 52 ].…”

Section: Mental Health Aspects Of Pulmonary Embolismmentioning

confidence: 99%

Mental Health and Quality of Life in Pulmonary Embolism: A Literature Review

Gkena

Kirgou

Gourgoulianis

et al. 2023

Advances in Respiratory Medicine

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Pulmonary embolismis an acute disease with chronic complications and, although it is not considered a chronic disease, it requires close follow-up. The scope of the present literature review is to decode the existing data concerning quality of life and the mental health impact of PE during the acute and long-term phases of the disease. The majority of studies reported impaired quality of life in patients with PE when compared to population norms, both in the acute phase and >3 months after PE. Quality of life improves over time, irrespectively of the measurement used. Fear of recurrences, elderly, stroke, obesity, cancer and cardiovascular comorbidities are independently associated with worse QoL at follow-up. Although disease specific instruments exist (e.g., the Pulmonary Embolism Quality of Life questionnaire), further research is required in order to develop questionnaires that may fulfil international guideline requirements. The fear of recurrences and the development of chronic symptoms, such as dyspnea or functional limitations, may further impair the mental health burden of PE patients. Mental health may be implicated by post-traumatic stress disorder, anxiety and depressive symptoms present following the acute event. Anxiety may persist for 2 years following diagnosis and may be exaggerated by persistent dyspnea and functional limitations. Younger patients are at higher risk of anxiety and trauma symptoms while elderly patients and patients with previous cardiopulmonary disease, cancer, obesity or persistent symptoms exhibit more frequently impaired QoL. The optimal strategy for the assessment of mental health in this patient pool is not well defined in the literature. Despite mental burden being common following a PE event, current guidelines have not incorporated the assessment or management of mental health issues. Further studies are warranted to longitudinally assess the psychological burden and elucidate the optimal follow-up approach.

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A Prospective Study Evaluating Cumulative Incidence and a Specific Prediction Rule in Pulmonary Embolism in COVID-19

Cited by 11 publications

References 41 publications

Predictive value of hematological indices on incidence and severity of pulmonary embolism in COVID‐19 patients

Predictive value of hematological indices on incidence and severity of pulmonary embolism in COVID‐19 patients

Prior COVID-19 Infection Predisposes to Worse Outcomes After Autologous Breast Reconstruction

Mental Health and Quality of Life in Pulmonary Embolism: A Literature Review

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