Abstract 15798: Prevalence and Effects of Pulmonary Embolism on Hospital Outcomes Among COVID-19 Patients

Abstract

Introduction: Approximately 531 million cases of coronavirus disease 2019 (COVID-19) has been reported globally, leading to 6.3 million deaths. Many studies have previous studies have reported that PE is a significantly dangerous complication of COVID-19. Therefore, we explored the prevalence of PE among COVID-19 hospitalizations. We also looked for the adverse effects of the coexistence of these two conditions using a large administrative database. Hypothesis: PE among COVID-19 hospitalizations could significantly increased the risk for adverse in-hospital outcomes. Methods: Using a retrospective analysis of the 2020 California State Inpatient Database we identified all COVID-19 hospitalizations and PE using ICD-10-CM codes among patients aged 18 years and above. Several outcomes such as in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission were explored for differences between those with and without PE. Prolonged length of stay was defined as hospital length of stay ≥75th percentile. We used multivariate logistic regression analyses to understand the relationship between PE and adverse hospital outcomes after accounting for cofactors. Results: A total of 94,114 COVID-19 hospitalizations were included for the analysis, of which 1798 (1.9%) had PE. COVID-19 hospitalizations with PE had significantly greater rates of adverse hospital outcomes such as mortality (19.5% versus 11.2%, P<0.001), prolonged length of stay (40.0% versus 28.2%, P<0.001), vasopressor use (4.6% versus 2.1%, P<0.001), mechanical ventilation (20.4% versus 9.9%, P<0.001), and ICU admission (19.6% versus 9.6%, P<0.001). PE significantly increased the odds of for mortality (aOR, 2.34, 95% CI: 2.07-2.65), prolonged length of stay (aOR, 3.51, 95% CI: 3.16-3.91), vasopressor use (aOR, 4.23, 95% CI: 3.78-4.74), mechanical ventilation (aOR, 2.90, 95% CI: 2.38-3.53), and ICU admission (aOR, 4.32, 95% CI: 3.85-4.84). Conclusions: Though very few COVID-19 hospitalizations in our cohort had PE, they had greater risk for adverse hospital outcomes and death. Given these adverse associations, PE among COVID-19 patients should be aggressively treated in order to decrease the disease burden of COVID-19.