Association Between Pulmonary Embolism and COVID-19 in Emergency Department Patients Undergoing Computed Tomography Pulmonary Angiogram: The PEPCOV International Retrospective Study
Por:
Freund, Y, Drogrey, M, Miro, O, Marra, A, Feral-Pierssens, A, Penaloza, A, Hernandez, B, Beaune, S, Gorlicki, J, Ayar, P, Truchot, J, Pena, B, Aguirre, A, Femy, F, Javaud, N, Chauvin, A, Chouihed, T, Montassier, E, Claret, P, Occelli, C, Roussel, M, Brigant, F, Ellouze, S, Le Borgne, P, Laribi, S, Simon, T, Lucidarme, O, Cachanado, M, Bloom, B and IMPROVING EMERGENCY CARE FHU
Publicada:
1 sep 2020
Ahead of Print:
1 sep 2020
Resumen:
Background There have been reports of procoagulant activity in patients with COVID-19. Whether there is an association between pulmonary embolism (PE) and COVID-19 in the emergency department (ED) is unknown. The aim of this study was to assess whether COVID-19 is associated with PE in ED patients who underwent a computed tomographic pulmonary angiogram (CTPA). Methods A retrospective study in 26 EDs from six countries. ED patients in whom a CTPA was performed for suspected PE during a 2-month period covering the pandemic peak. The primary endpoint was the occurrence of a PE on CTPA. COVID-19 was diagnosed in the ED either on CT or reverse transcriptase-polymerase chain reaction. A multivariable binary logistic regression was built to adjust with other variables known to be associated with PE. A sensitivity analysis was performed in patients included during the pandemic period. Results A total of 3,358 patients were included, of whom 105 were excluded because COVID-19 status was unknown, leaving 3,253 for analysis. Among them, 974 (30%) were diagnosed with COVID-19. Mean (+/- SD) age was 61 (+/- 19) years and 52% were women. A PE was diagnosed on CTPA in 500 patients (15%). The risk of PE was similar between COVID-19 patients and others (15% in both groups). In the multivariable binary logistic regression model, COVID-19 was not associated with higher risk of PE (adjusted odds ratio = 0.98, 95% confidence interval = 0.76 to 1.26). There was no association when limited to patients in the pandemic period. Conclusion In ED patients who underwent CTPA for suspected PE, COVID-19 was not associated with an increased probability of PE diagnosis. These results were also valid when limited to the pandemic period. However, these results may not apply to patients with suspected COVID-19 in general.
Filiaciones:
Freund, Y:
Sorbonne Univ, Paris, France
Hop La Pitie Salpetriere, AP HP, APHP SU, Emergency Dept, Paris, France
Drogrey, M:
Hop La Pitie Salpetriere, AP HP, APHP SU, Emergency Dept, Paris, France
Miro, O:
Hosp Clin Barcelona, Emergency Dept, Barcelona, Catalonia, Spain
Marra, A:
ASST Papa Giovanni XXIII Hosp, Emergency Dept, Ctr EAS Emergenza Alta Specializzaz, Bergamo, Italy
Feral-Pierssens, A:
Sherbrooke Univ, Charles Lemoyne Saguenay Lac St Jean Res Ctr Hlth, Longueuil, PQ, Canada
Hop Europeen Georges Pompidou, APHP, Emergency Dept, Paris, France
Penaloza, A:
Univ Catholic Louvain, Clin Univ St Luc, Serv Urgences, Louvain La Neuve, Belgium
Hernandez, B:
Pontificia Univ Catolica Chile, Emergency Med Sect, Santiago, Chile
Beaune, S:
Univ Paris Ctr, Hop Ambroise Pare, APHP, Emergency Dept,INSERM,UMR 1144, Boulogne, France
Gorlicki, J:
Avicenne Univ Hosp, APHP HUPSSD, Emergency Dept, SAMU 93, Bobigny, France
Sorbonne Paris Nord Univ, INSERM, UMR S 942, Bobigny, France
Ayar, P:
Univ Hosp Beaujon, APHP, Emergency Dept, Clichy, France
MASCOT, INSERM, UMR S 942, Paris, France
Univ Paris, Paris, France
Truchot, J:
Hop Univ Paris Ctr, Cochin Hosp, APHP, Emergency Dept, Paris, France
:
Hosp Gen Univ Alicante, Emergency Dept, Alicante, Spain
Aguirre, A:
Hosp del Mar, Emergency Dept, Barcelona, Catalonia, Spain
Femy, F:
Univ Paris, Georges Pompidou European Hosp, APHP, Emergency Dept, Paris, France
French Armed Forces Biomed Inst, Toxicol & Chem Risks Dept, Bretigny Sur Orges, France
Javaud, N:
Univ Paris, Louis Mourier Hosp, APHP North, Emergency Dept, Paris, France
Chauvin, A:
Hop Lariboisiere, AP HP, Emergency Dept, Paris, France
Univ Paris, Fac Med, Paris, France
Chouihed, T:
Univ Lorraine, Univ Hosp Nancy, Emergency Dept, Ctr Invest Clin 1433, Nancy, France
INSERM, UMR S 1116, Nancy, France
F CRIN INI CRCT, Nancy, France
Montassier, E:
CHU Nantes, Dept Emergency Med, Nantes, France
Univ Nantes, MiHAR Lab, Nantes, France
Claret, P:
Nimes Univ Hosp, Dept Anesthesia Resuscitat Pain Emergency Med, Nimes, France
Occelli, C:
CHU Pasteur 2, Emergency Dept, Nice, France
Univ Nice Cote dAzur, Nice, France
Roussel, M:
Rouen Univ Hosp, Emergency Dept, Rouen, France
Brigant, F:
Hop St Antoine, APHP SU, Emergency Dept, Paris, France
Ellouze, S:
Hop St Louis, APHP, Emergency Dept, Paris, France
Le Borgne, P:
Hop Univ Strasbourg, Emergency Dept, Strasbourg, France
Univ Strasbourg, French Natl Inst Hlth & Med Res, Regenerat NanoMed RNM, Federat Med Translat FMTS,INSERM,UMR 1260, Strasbourg, France
Laribi, S:
Tours Univ, Sch Med, Emergency Dept, Tours, France
Tours Univ, CHU Tours, Tours, France
Simon, T:
Sorbonne Univ, Paris, France
Hop St Antoine, AP HP, Clin Res Platform URC CRC CRB, Paris, France
Lucidarme, O:
Sorbonne Univ, Paris, France
Sorbonne Univ, Pitie Salpetriere Hosp, APHP, Radiol Dept, Paris, France
UPMC Univ Paris 06, CNRS, INSERM, Lab Imagerie Biomed, Paris, France
Cachanado, M:
Royal London Hosp, Emergency Dept, Barts Hlth NHS Trust, London, England
Bloom, B:
Hop Europeen Georges Pompidou, APHP, Emergency Dept, Paris, France
Green Submitted, Green Accepted, Bronze
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