HealthDay News — COVID-19 is associated with a high rate of pulmonary embolism, according to two research letters published online April 23 in Radiology.

Ian Leonard-Lorant, MD, from the Nouvel Hôpital Civil in Strasbourg, France, and colleagues described the rate of pulmonary embolus in 106 patients classified as having COVID-19 infection who underwent pulmonary computed tomography (CT) angiography. The researchers found that 30% of the patients with COVID-19 had positive findings for acute pulmonary emboluson pulmonary CT angiogram; the remaining patients had negative findings on CT. D-dimer levels were higher in patients with COVID-19 infection and pulmonary embolus vs those without pulmonary embolus (median, 6,110±4,905 vs 1,920±3,674 µg/L, respectively), and patients with COVID-19 infection and pulmonary embolus were more likely to be in the intensive care unit (75% vs 32%). A D-dimer level greater than 2,660 µg/L had a sensitivity of 100% and specificity of 67% for pulmonary embolism on CT angiography.

Franck Grillet, MD, from Centre Hospitalier Universitaire de Besancon in France, and colleagues examined pulmonary embolus in association with COVID-19 infection using pulmonary CT angiography. A total of 100 hospitalized patients with COVID-19 infection and severe clinical features were examined with contrast-enhanced CT. The researchers found that 23% of the patients had acute pulmonary embolism. Patients with pulmonary embolism were more frequently in the critical care unit (74% vs 29% without); they also required mechanical ventilation more often (65% vs 25%) Requirement for mechanical ventilation remained associated with acute pulmonary embolism in a multivariable analysis (odds ratio, 3.8).

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“Our results suggest that patients with severe clinical features of COVID-19 may have associated acute pulmonary embolus,” Grillet and colleagues write. “Therefore, the use of contrast enhanced CT rather than routine non-contrast CT may be considered for these patients.”

Abstract/Full Text — Leonard-Lorant (subscription or payment may be required)

Abstract/Full Text — Grillet (subscription or payment may be required)