Acute phase characteristics and long-term complications of pulmonary embolism in COVID-19 compared to non-COVID-19 cohort: a large single-centre study

IntroductionPulmonary embolism (PE) is a well-recognised complication of COVID-19 infection, and chronic thromboembolic pulmonary disease with and without pulmonary hypertension (CTEPD/CTEPH) are potential life-limiting consequences. At present the burden of CTEPD/CTEPH is unclear and optimal and cost-effective screening strategies yet to be established.MethodsWe evaluated the CTEPD/CTEPH referral rate to the UK national multidisciplinary team (MDT) during the 2017–2022 period to establish the national incidence of CTEPD/CTEPH potentially attributable to COVID-19-associated PE with historical comparator years. All individual cases of suspected CTEPH were reviewed by the MDT for evidence of associated COVID-19. In a separate multicentre cohort, the risk of developing CTEPH following hospitalisation with COVID-19 was calculated using simple clinical parameters at a median of 5 months post hospital discharge according to existing risk scores using symptoms, ECG and NT pro-BNP.ResultsBy the second year of the pandemic, CTEPH diagnoses had returned to the pre-pandemic baseline (23.1versus27.8 cases per month, p=0.252). Of 334 confirmed CTEPD/CTEPH cases, 4 (1.2%) patients were identified to have CTEPH potentially associated with COVID-19 PE, and a further 3 (0.9%) CTEPD without PH. Of 1094 patients (mean age 58 years, 60.4% male) hospitalised with COVID-19 screened across the UK, 11 (1.0%) were at high risk of CTEPH at follow-up, none of whom had a diagnosis of CTEPH made at the national MDT.ConclusionA-priori risk of developing CTEPH following COVID-19-related hospitalisation is low. Simple risk scoring is a potentially effective way of screening patients for further investigation.

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Clinical features of pulmonary embolism in patients with previous recent COVID-19 infection

Kononov,

Solovev,

Kraev

et al. 2023

Russian Medicine

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BACKGROUND: Pulmonary embolism (PE) is one of the most significant thromboembolic complications of coronavirus disease 2019 (COVID-19). Several studies have demonstrated the clinical features of PE in patients in the acute phase of COVID-19. The features of the course of PE diagnosed after an acute infection have not been sufficiently studied. AIM: To study the clinical picture of PE that occurred within 3 months after COVID-19. METHODS: A retrospective study was completed. Patients were hospitalized with a diagnosis of PE between January 2020 and December 2021. Two subgroups were formed: with a history of recent (up to 3 months) COVID-19 infection and without a history of COVID-19. RESULTS: Of the 278 patients hospitalized with PE, 44 had anamnesis of COVID-19, and 69 had no anamnesis of infection. In the remaining 165 patients with PE, determining the presence or absence of a history of COVID-19 was impossible. In the analysis of the clinical picture and examination results of 44 patients with COVID-19, distal localization of thrombotic lung lesions was predominant, the incidence of deep vein thrombosis of the lower extremities was lower, and right heart lesions were noted. A tendency toward the presence of diabetes mellitus, anemia, and thrombocytopenia was found. CONCLUSION: Patients with PE and history of COVID-19 have features of clinical presentation. The identified signs are consistent with the results of studies that have evaluated the course and clinical signs of PE in the acute period of COVID-19. Similar manifestations may indicate a significant effect of COVID-19 on PE signs both during and after the acute period of COVID-19. Clinical features were determined by the severity of the previous infection.

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Acute phase characteristics and long-term complications of pulmonary embolism in COVID-19 compared to non-COVID-19 cohort: a large single-centre study

Cited by 4 publications

References 22 publications

The thromboembolic effect of COVID-19

The thromboembolic effect of COVID-19

Chronic thromboembolic pulmonary hypertension is an uncommon complication of COVID-19: UK national surveillance and observational screening cohort studies

Clinical features of pulmonary embolism in patients with previous recent COVID-19 infection

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