Pulmonary Embolism and COVID-19: A Diagnostic Dilemma – A German Single Centre Experience

Abstract

Background/Objective: The high predisposition to pulmonary embolism (PE) in CoViD-19-patients increases with its seriousness, even under anticoagulation. Because neither clinical nor laboratory parameters seem to be specific in this case, the CTPA stays the gold standard for further diagnostic, with the risk however of overuse. Our study investigates the incidence of PE in CoViD-19-patients, who underwent aCTPA, and to assess the link of several clinical and laboratory parameters with its occurrence. Methods:We led a retrospective monocentric study in Johanniter Hospital in Duisburg-Rheinhausen between April 1 st , 2020, and October 26 th , 2021, in patients CoViD-19 positive tested with a RT-PCR. Data about examined CoViD-19 patients with CTPA by PE suspicion or accidentally revealed PE were collected, as well as clinical and laboratory parameters too.Results: among 330 CoViD-19-patients 52 (15.8%) underwent a CTPA. 9 Patients (17.3% of 52/2.7% of 330) showed a PE. By 4 patients (7.7% of 52/1.2% of 330) PE could not be excluded. Only the Caucasian race (OR -6.25; 95% CI 1.140-34.290; p = 0.035) was found to be independently associated with PE. Conclusion:Clinical and laboratory parameters are insufficient to clarify the occurrence of PE in patients with CoViD-19. Because of its seriousness and its relative higher incidence in CoViD-19-patients a lower barrier based on clinical appearance of the disease degree is required in the future to evocate the possibility of a PE and to include earliest possible the performance of a CTPA for evaluation.