D-dimer levels and acute pulmonary embolism development in COVID-19 patients

Abstract

Objective. To identify those who develop pulmonary embolism with Ddimer levels by evaluating pulmonary CT angiographies of patients who are followed up with suspicion of coronavirus disease 2019 (COVID-19). Methods. Patients who were followed up in a community hospital with suspicion of COVID-19 and underwent Pulmonary CT angiography examination were evaluated. Clinical and demographic parameters and DDimer values for patients with and without pulmonary embolism were evaluated in the pulmonary CT angiogram. Results. During the COVID-19 pandemic, Thorax CT examination was performed in our center for suspicion or follow-up of COVID-19 infection in 3396 patients. Pulmonary CT angiography was applied to 312 (9.2%) of these cases. Of these 312 patients, 141 were identified as COVID-19 patients. Acute pulmonary embolism was detected in 33 (23.4%) of 141 patients with COVID-19 and pulmonary CT angiogram. D-dimer levels (5964.97±4036.8 μg/L) of patients with COVID-19 infection and pulmonary embolism were significantly higher than D-dimer levels (972.4±1766.8 μg/L) of patients without pulmonary embolism. In patients with COVID-19 infection, a Ddimer value higher than 1013 μg/L was determined as a cut-off value with 100% sensitivity for the presence of pulmonary embolism. Conclusions. For those struggling with the COVID-19 pandemic, pulmonary embolism should be kept in mind if D-dimer values increase more than expected in the presence of respiratory distress that Thorax CT findings cannot explain.