Abstract:
Although pulmonary embolism (PE) is a frequent complication in COVID-19, its consequences remain unknown. We performed pulmonary function tests, echocardiography and computed tomography pulmonary angiography and identified blood biomarkers in a cohort of consecutive hospitalized COVID-19 patients with pneumonia to describe and compare medium-term outcomes according to the presence of PE, as well as to explore their potential predictors. A total of 141 patients (56 with PE) were followed up during a median of 6 months. Post-COVID-19 radiological lung abnormalities (PCRLA) and impaired diffusing capacity for carbon monoxide (DLCOc) were found in 55.2% and 67.6% cases, respectively. A total of 7.3% had PE, and 6.7% presented an intermediate-high probability of pulmonary hypertension. No significant difference was found between PE and non-PE patients. Univariate analysis showed that age > 65, some clinical severity factors, surfactant protein-D, baseline C-reactive protein, and both peak red cell distribution width and Interleukin (IL)-10 were associated with DLCOc < 80%. A score for PCRLA prediction including age > 65, minimum lymphocyte count, and IL-1β concentration on admission was constructed with excellent overall performance. In conclusion, reduced DLCOc and PCRLA were common in COVID-19 patients after hospital discharge, but PE did not increase the risk. A PCRLA predictive score was developed, which needs further validation.
摘要:
尽管肺栓塞(PE)是COVID-19的常见并发症,但其后果仍然未知。我们做了肺功能检查,在一组连续住院的COVID-19肺炎患者中,超声心动图和计算机断层扫描肺动脉造影以及确定的血液生物标志物,以根据是否存在PE来描述和比较中期结局,以及探索他们潜在的预测因素。总共141例患者(56例PE)获得随访,中位时间为6个月。在55.2%和67.6%的病例中发现了COVID-19后放射性肺异常(PCRLA)和一氧化碳弥散能力受损(DLCOc),分别。共有7.3%的人有PE,6.7%的患者出现肺动脉高压的概率为中高。PE和非PE患者之间没有发现显着差异。单因素分析显示,年龄>65岁,一些临床严重程度因素,表面活性剂蛋白-D,基线C反应蛋白,红细胞峰值分布宽度和白细胞介素(IL)-10与DLCOc<80%相关。PCRLA预测的评分包括年龄>65,最小淋巴细胞计数,入院时IL-1β浓度构建具有优异的整体性能。总之,在出院后的COVID-19患者中,DLCOc和PCRLA降低是常见的,但PE并没有增加风险。制定了PCRLA预测评分,这需要进一步验证。