背景:在2020年荷兰首次COVID-19爆发期间,在入住重症监护病房(ICU)的COVID-19患者中,肺栓塞(PE)的发生率似乎较高.本研究旨在评估未入住ICU的COVID-19患者住院期间PE的发生率。
方法:数据来自荷兰的8家医院。包括2020年2月27日至2020年7月31日期间收治的患者。提取的数据包括临床特征,药物使用,首次出现COVID-19相关症状,COVID-19的入院日期和PE诊断日期。仅包括聚合酶链反应(PCR)阳性患者。所有PE均通过计算机断层扫描肺动脉造影(CTPA)诊断。
结果:收集了1,852例住院患者的数据。40名患者(2.2%)在入院后28天内被诊断为PE。自入院以来的平均PE时间为4.5天(IQR0.0-9.0)。在所有40名患者中,在入院后的前2周内诊断出PE,在出现症状后2周内诊断出22例(55%)患者。患者特征,预先存在的合并症,抗凝剂的使用,入院时的实验室参数与PE的发展无关。
结论:在这项仅入住非ICU病房的1,852例COVID-19患者的回顾性多中心队列研究中,CTPA证实的PE在症状出现后的前4周内的发生率为2.2%,仅发生在入院后2周内.
BACKGROUND: During the first COVID-19 outbreak in 2020 in the Netherlands, the incidence of pulmonary embolism (PE) appeared to be high in COVID-19 patients admitted to the intensive care unit (ICU). This study was performed to evaluate the incidence of PE during hospital stay in COVID-19 patients not admitted to the ICU.
METHODS: Data were retrospectively collected from 8 hospitals in the Netherlands. Patients admitted between February 27, 2020, and July 31, 2020, were included. Data extracted comprised clinical characteristics, medication use, first onset of COVID-19-related symptoms, admission date due to COVID-19, and date of PE diagnosis. Only polymerase chain reaction (PCR)-positive patients were included. All PEs were diagnosed with computed tomography pulmonary angiography (CTPA).
RESULTS: Data from 1,852 patients who were admitted to the hospital ward were collected. Forty patients (2.2%) were diagnosed with PE within 28 days following hospital admission. The median time to PE since admission was 4.5 days (IQR 0.0-9.0). In all 40 patients, PE was diagnosed within the first 2 weeks after hospital admission and for 22 (55%) patients within 2 weeks after onset of symptoms. Patient characteristics, pre-existing comorbidities, anticoagulant use, and laboratory parameters at admission were not related to the development of PE.
CONCLUSIONS: In this retrospective multicenter cohort study of 1,852 COVID-19 patients only admitted to the non-ICU wards, the incidence of CTPA-confirmed PE was 2.2% during the first 4 weeks after onset of symptoms and occurred exclusively within 2 weeks after hospital admission.