Late Breaking Abstract - Incidence, risk factors and thrombotic load of pulmonary embolism in patients hospitalized with COVID-19

Abstract

<b>Objective:</b> To determine the incidence of PE in a representative cohort of patients hospitalized with COVID-19 pneumonia, and to assess the risk factors of PE during hospitalization to construct a predictive score for PE. <b>Patients and Methods:</b> We performed a prospective observational study of a randomly selected cohort of consecutive patients hospitalized for COVID-19 pneumonia between March 8 to April 25, 2020. All eligible patients underwent a computed tomography pulmonary angiography independently of their PE clinical suspicion and were pre-screened for a baseline elevated D-dimer level (≥500 ng/mL). <b>Results:</b> 119 patients were randomly selected from the 372 admitted to one tertiary hospital in Spain for COVID-19 infection. Finally, 73 patients were valid for analysis (Table 1). Despite a high level of pharmacological thromboprophylaxis (89%), PE was confirmed in 26 patients (35.6%; 95% CI, 29.6 to 41.6%), mostly with a peripheral location and low thrombotic load (Qanadli score, 18.5%). Multivariate analysis showed that heart rate (HR 1.04), room-air oxygen saturation (spO2) (HR, 0.87), D-dimer (HR 1.02), and C-reactive protein (CRP) levels (HR 1.01) at the time of admission were independent predictors of incident PE during hospitalization. A risk score (CHOD score, table 2, fig1) was constructed with these four variables showing a high predictive value of incident PE. <b>Conclusions:</b> Our findings confirmed a high incidence of PE in hospitalized COVID-19 patients. Heart rate, SpO2, D-dimer, and CRP levels at admission were associated with higher rates of PE during hospitalization.