Clinical Differences and Outcomes of COVID-19 Associated Pulmonary Thromboembolism in Comparison with Non-COVID-19 Pulmonary Thromboembolism

Abstract

(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been reported to increase the risk of pulmonary thromboembolism (PTE). The aim of this study is to elucidate whether Coronavirus disease COVID-19-associated PTE has a different clinical expression than non-COVID-19 PTE due to a different pathophysiology. (2) Methods: retrospective study of PTE episodes conducted at our hospital between January 2019 and December 2020, comparing the group of COVID-19-associated PTE patients with a control group of non-COVID-19 PTE patients. (3) Results: A total of 229 patients with PTE were registered, 79 of whom had COVID-19. Cancer (15.2% vs. 39.3%; p < 0.001), previous surgery (0% vs. 8%; p = 0.01), previous VTE (2.5% vs. 15.3%; p = 0.003), signs and/or symptoms of deep venous thrombosis (DVT) (7.6% vs. 22.7%; p = 0.004) and syncope (1.3% vs. 8.1%; p = 0.035) were less frequent in the COVID-19 group. Central thrombosis was more frequent in the control group (35.3% vs. 13.9%; p = 0.001). No VTE recurrent episodes were observed in the COVID-19 group, whereas four (2.7%) episodes were recorded for the control group. One-month bleeding rate was higher in the COVID-19 group (10.1% vs. 1.3%; p = 0.004). (4) Conclusion: COVID-19-associated PTE has clinical characteristics that differ from those of PTE without COVID-19, including inferior severity and a lower rate of VTE recurrence. Physicians should be aware of the high risk of bleeding in the first month of COVID-19-associated PTE.

COVID-19 and Pulmonary Embolism Outcomes among Hospitalized Patients in the United States: A Propensity-Matched Analysis of National Inpatient Sample

“…Similarly, a New York Health System reported patients with COVID-19 WPE had a mortality rate of 20%, which is parallel to our study [14]. Cossio et al reported that in comparison to non-COVID PE, Patients with COVID-19 with PE were less likely to have classic risk factors and symptoms of venous thromboembolism, however no mortality difference was noted at 1 year [15]. Similarly, Miro et al replicated the same results as Cossio et al, however in-hospital mortality was 16% in COVID-19-related PE vs. non-COVID PE.…”

Detección de tromboembolismo pulmonar en pacientes con COVID-19: descripción de una cohorte en un hospital terciario chileno

“…Si bien la infección pulmonar y la inmovilidad son factores de riesgo clásicos para la aparición de enfermedad tromboembólica, 4 se ha descrito un aumento de la incidencia de 2 a 4 veces en pacientes con diagnóstico de COVID-19. 5,6 Ello ha planteado la existencia de factores de riesgo específicos asociados a la infección viral. Diversos mecanismos fisiopatológicos se han descrito en tromboembolismo pulmonar en pacientes COVID-19, como la aparición de multímeros de alto peso molecular de factor von Willebrand y la NETosis de neutrófilos como marcadores de disfunción endotelial; 7-9 además de los factores sistémicos propios de la infección por SARS-COV-2 como son el estado proinflamatorio e inmovilidad asociada a la hospitalización.…”