Cardiology Letters 2022, 31(3):196-201

Pulmonary embolism and Covid-19

Čambál D¹, Molnárová K¹, Petruš P¹, Haršány J², Klepanec A²

¹ Oddelenie kardiológie, FN Trnava

² Rádiologická klinika, FN Trnava, Slovenská republika

Aims: Patients with pulmonary embolism (PE) have different in-hospital mortality rates depending on their comorbidities and the grade of the obstruction of the pulmonary artery. In this study, we observed whether Covid-19 infection had a worsening impact on prognosis in patients affected by PE. We also analysed the significance of known risk factors such as Troponin levels, NTproBNP levels, D-dimer, arterial blood lactate, and CRP levels in patients with Covid-19 associated PE.

Methods: In this prospective cohort study, we observed patients hospitalised during the second wave of the Covid-19 pandemic in Trnava. Patients were divided into two groups, 1. patients with covid-19 associated PE (Covid+), and 2. patients with PE without Covid-19 infection as a control group (Covid-). We compared clinical findings, imaging findings, laboratory results and in-hospital mortality between these two groups.

Results: In this prospective study, we analysed data from 74 patients. Median age of patients was 69.5 (IQR 58-77). We identified 26 (35%) Covid+ patients. Covid+ patients had a longer hospitalisation [11 (IQR 8-17) days vs 8 (IQR 6.25-10) days, p = 0.004] and significantly higher in-hospital mortality than Covid-group (23% vs 2%, p=0.0065). The combined risk of in-hospital mortality and hemodynamic decompensation was similar in both groups (23% vs 8%, P=0.15). Nonfatal bleeding was reported overall in 4 patients (5.4%) without any significant difference between the two groups (8% vs 4%, p=0,6). From laboratory tests, only NT-proBNP levels had shown the difference between our groups. Despite lower levels of NT-proBNP in Covid + group [300.5 (182-2755.5) vs 1372 (5405420.5) pg/ml, p = 0.03], mortality rate was higher in these patients.

Conclusion: The Covid+ group had significantly higher in-hospital mortality, which pointed out the negative impact of Covid-19 infection on patients with PE.

Keywords: Covid-19; pulmonary embolism; in-hospital mortality

Published: March 1, 2022  Show citation