Abstract 15152: One-Year Evolution of Patients With Pulmonary Embolism During the Highest Epidemic Peak of COVID-19: COVID-EP Study

Abstract

Introduction: During the first COVID peak, among patients admitted to intensive care unit, pulmonary embolism (PE) diagnosis frequency was high. In April 2020 (highest epidemic peak of COVID), no PE management guidelines were effective, and PE evolution in this context was uncertain. Although several studies had explored a potential link between COVID and PE, none had focused on PE evolution according to COVID status excepted for death and short-term complications. Hypothesis: Our aim was to investigate whether COVID status and/or treatments used at the time of PE could affect PE evolution in longer-term. Aims: The main objectives were: (1) To assess the occurrence at 6 and 12 months after PE diagnosis of one of the following complications of interest: interstitial pathology, recurrence of PE, pulmonary arterial hypertension (PAH) or death, (2) to investigate the impact of the treatment dispensed on PE evolution. Methods: A National multicenter prospective cohort study was conducted in patients diagnosed with PE in April 2020. Patients were divided into two groups according to their COVID viral status (COVID-positive and COVID-negative) and were followed up to 12 months. Results: A total of 87 patients were included into 12 centers. No difference in global complication rates was observed between the groups at 6 and 12 months (p=0.4682 and p=0.5045 respectively). However, we observed that COVID-Positive patients had more interstitial pathology at 3, 6 and 12 months than COVID-Negative patients (p=0.0075, p=0.0088 and p=0.0033 respectively). Furthermore, the PE complication rate was significantly higher in patients treated with heparin-alone in COVID-negative patients (p=0.0002). Conclusions: COVID status did not appear to influence PE evolution, in accordance with the literature. Interstitial pathology has recently been shown to be a complication of COVID, which may explain its higher incidence in the COVID-positive group. Because of the exceptional context of the COVID pandemic in which this study was conducted and the short duration of inclusion, it might be interesting to confirm these results with a study on a larger population and over a longer period, in order to possibly update the management of patients with PE.