Pulmonary embolism severity and in-hospital mortality: An international comparative study between COVID-19 and non-COVID patients

Miró, Òscar; Jiménez, Sònia; Llorens, Pere; Roussel, Mélanie; Gorlicki, Judith; García‐Lamberechts, Eric Jorge; Borgne, P. Le; Jacob, Javier; Chauvin, Anthony; Lucidarme, Olivier; Burillo-Putzé, Guillermo; Aguirre, Alfons; Brigant, Fabien; Lozano, Laura; Castillo, Juan González del; Freund, Yonathan

doi:10.1016/j.ejim.2022.01.035

Cited by 15 publications

(13 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results show that although severity markers, including sPESI score, the need for mechanical ventilation, or a longer length of stay, were more frequent in COVID patients, in-hospital mortality was lower. These results disagree with the previous analysis of the SIESTA and PEPCOV research teams [ 16 ]. In this study conducted by Miró et al in 62 Spanish and 16 French hospitals, the in-hospital mortality was higher in COVID patients.…”

Section: Discussioncontrasting

confidence: 99%

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

Franco‐Moreno

Brown-Lavalle²,

Campos-Arenas³

et al. 2023

BMC Pulm Med

View full text Add to dashboard Cite

Background To compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death are valid in this population. Methods We retrospectively included hospitalized patients with PE from 1 January 2016 to 31 December 2022. Comparisons for acute episode characteristics, risk stratification of the PE, outcomes, and long-term complications were made between COVID and non-COVID patients. Results We analyzed 116 (27.5%) COVID patients and 305 (72.4%) non-COVID patients. In patients with COVID-19, the traditional risk factors for PE were absent, and the incidence of deep vein thrombosis was lower. COVID patients showed significantly higher lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels. COVID patients had PE of smaller size (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental and 13.2% vs. 7.9% subsegmental, respectively; p < 0.001), less right ventricular dysfunction (7.7% vs. 17.7%; p = 0.007) and higher sPESI score (1.66 vs. 1.11; p < 0.001). The need for mechanical ventilation was significantly higher in COVID patients (8.6% vs. 1.3%; p < 0.001); However, the in-hospital death was less (5.2% vs. 10.8%; p = 0.074). The incidence of long-term complications was lower in COVID cohort (p < 0.001). PE severity assessed by high sPESI and intermediate and high-risk categories were independently associated with in-hospital mortality in COVID patients. Conclusion The risk of in-hospital mortality and the incidence of long-term complications were lower in COVID-19. The usual tools for risk stratification of PE are valid in COVID patients.

show abstract

Section: Discussioncontrasting

confidence: 99%

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

Franco‐Moreno

Brown-Lavalle²,

Campos-Arenas³

et al. 2023

BMC Pulm Med

View full text Add to dashboard Cite

show abstract

“…Studies have evaluated the usefulness of the PESI scale in the context of PE secondary to COVID-19. Miró et al 21 showed a higher mortality in patients with PE secondary to COVID-19 compared to PE not secondary to COVID-19 (12.8 vs 5.3%, p < 0.001). Their results suggest an underestimation of in-hospital mortality with different scores on the sPESI scale (simplified PESI) in patients with PE secondary to COVID-19 compared to PE not caused by COVID-19 (sPESI 0 p = 0.003, sPESI 1 p = 0.028, sPESI, 2 p = 0.012, sPESI>2 p = 0.055).…”

Section: Discussionmentioning

confidence: 95%

Validation of the PESI Scale to Predict in-Hospital Mortality in Patients with Pulmonary Thromboembolism Secondary to SARS CoV − 2 Infection

Muñoz

Ruiz-Talero

Hernández-Flórez

et al. 2022

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

Objective To evaluate the discriminative ability and the calibration of the Pulmonary Embolism Severity Index (PESI) to predict in-hospital mortality in patients with Pulmonary Embolism (PE) secondary to COVID 19 in two hospitals in Bogotá. Methods External validation study of a prediction model based on a retrospective cohort of patients with PE secondary to COVID-19 treated at Hospital Universitario San Ignacio and Hospital universitario La Samaritana, between March 2020 and August 2021. Calibration of the scale was evaluated using the Hosmer-Lemeshow test and a calibration belt diagram. Discrimination ability was evaluated using a ROC curve. Results 272 patients were included (median age 61.5 years, male 58.8%). PE was diagnosed in 45.6% of the patients at the time of admission. Of the remaining 54.4%, 95.9% received thromboprophylaxis until the time of diagnosis.17.6% of the patients died. Regarding calibration, the scale systematically underestimates risk in all classes of PESI. For class I, the ratio of observed/expected events was 4.4 vs 0.8%, class II 4.8 vs 1.8%, class III 15.2 vs 4.2%, class IV 14.3 vs 5.9% and class V 46.7 vs 5.8%. The calibration test rejected the adequate calibration hypothesis (p < 0.001). The discriminatory ability was adequate (AUC = 0.7128, 95% CI 0.63-0.79). Conclusions The PESI scale in patients with PE secondary to COVID 19 underestimates the risk of in-hospital mortality, while maintaining adequate discrimination. It is suggested not to use the PESI scale until it is recalibrated in this context.

show abstract

“…If PE or DVT was diagnosed, all patients were treated with therapeutic anticoagulation, if no contraindications existed. Miró et al showed in a recent published study, that PE in COVID-19 patients was associated with less severity than in Non-COVID patients [38] . This could also be an explanation for the missing relevance of PE for mortality in our cohort.…”

Section: Discussionmentioning

confidence: 96%

Characteristics and outcomes of sepsis patients with and without COVID-19

Heubner

Hattenhauer

Güldner

et al. 2022

Journal of Infection and Public Health

View full text Add to dashboard Cite

Pulmonary embolism severity and in-hospital mortality: An international comparative study between COVID-19 and non-COVID patients

Cited by 15 publications

References 26 publications

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

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

Validation of the PESI Scale to Predict in-Hospital Mortality in Patients with Pulmonary Thromboembolism Secondary to SARS CoV − 2 Infection

Characteristics and outcomes of sepsis patients with and without COVID-19

Contact Info

Product

Resources

About