Acute pulmonary embolism in COVID-19 disease: Preliminary report on seven patients

Pompilio Faggiano, Andrea Bonelli, Sara Paris, Giuseppe Milesi, Stefano Bisegna, Nicola Bernardi, Antonio Curnis, Eustachio Agricola, Roberto Maroldi

Research output: Contribution to journalArticlepeer-review

Abstract

There is some evidence that Covid 19 pneumonia is associated with prothrombotic status and increased risk of venous thromboembolic events (deep venous thrombosis and pulmonary embolism). Over a two-week period we admitted in our Unit 25 patients with Covid-19 pneumonia, of these pulmonary embolism was diagnosed using computed tomography angiography in 7. We report on clinical and biochemical features of these patients. They were all males, with a mean age of 70.3 years (range 58–84); traditional risk factors for venous thromboembolism were identified in the majority of patients with pulmonary embolism, however not differently from those without pulmonary embolism. Clinical presentation of pulmonary embolism patients was usually characterized by persistence or worsening of respiratory symptoms, with increasing oxygen requirement. D-dimer levels were several fold higher than the upper threshold of normal; in patients in whom PE was recognized during hospital stay, a rapid and relevant increase of D-dimer levels was observed. Computed tomographic findings ranged from massive acute pulmonary embolism to a segmental or sub-segmental pattern; furthermore, thrombosis of sub-segmental pulmonary arteries within lung infiltrates were occasionally seen, suggesting local mechanisms. Six out of 7 patients were treated with unfractionated or low molecular weight heparin with clinical benefit within few days; one patient needed systemic thrombolysis (death from hemorrhagic complication).

Original languageEnglish
Pages (from-to)129-131
Number of pages3
JournalInternational Journal of Cardiology
Volume313
DOIs
Publication statusPublished - Aug 15 2020

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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