Pulmonary embolism and COVID-19

In a brand new examine revealed not too long ago within the journal Radiology, researchers discovered that 51 p.c of sufferers discovered to have a pulmonary embolism, or PE, had been identified within the Emergency Division, the entry level for sufferers being admitted to the hospital.

In Europe, analysis has proven that almost all circumstances of PE had been identified in sufferers admitted to the intensive care unit after being on a ventilator for a number of days.

Within the Henry Ford examine, researchers say 72 p.c of PE diagnoses had been in sufferers who didn’t require “ICU-level care,” suggesting that well timed analysis and use of blood thinners may have performed a task within the therapy course of.

“Based mostly on our examine, early detection of PE may additional improve and optimize therapy for sufferers first presenting within the Emergency Division,” says Pallavi Bhargava, M.D., an infectious illnesses doctor concerned within the examine. “We advise clinicians to consider PE as a further complication early on throughout the admission of sufferers whose signs and lab outcomes level to that situation.”

Thomas Track, M.D., a radiologist and the examine’s senior creator, says a well timed pulmonary CT angiography made the distinction within the PE analysis. “We advocate CT angiography as a result of a standard CT scan might not decide up the blood clot,” Dr. Track says.

Along with the early detection discovering, different key highlights emerged from the retrospective examine of 328 COVID-19 sufferers who underwent a pulmonary CT angiography between March 16 and April 18 at Henry Ford’s acute care hospitals:

• 22 p.c of sufferers had been discovered to have a pulmonary embolism.
• Sufferers with a BMI (physique mass index) of 30 or increased are almost 3 times extra in danger for growing a pulmonary embolism. The perfect BMI for adults is 18.5 — 24.9.
• Sufferers on statin remedy previous to admission had been much less prone to develop a pulmonary embolism.
• Elevated D-dimer and C-reactive protein lab markers, at the side of a rising oxygen requirement, could also be a predictor of a pulmonary embolism, even when sufferers are receiving preventive blood thinners.

“Our findings counsel that sufferers who take a look at optimistic for COVID-19 must be began on preventive blood thinners early on of their therapy and that the necessity for CT angiography be assessed on a case by case foundation to search for blood clots,” Dr. Bhargava says. “Our ER docs performed a key function in meticulously assessing these sufferers, evaluating their d-dimer marker worth and ordering the suitable CT scans to establish these blood clots so early within the analysis.”

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