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title:Correlation between Pulmonary Thromboembolic Complications Detected by CT Pulmonary Angiography in COVID-19 Pneumonia Patients with Clinical, D-dimer Level, CTSI Score and its Prognostic Implication- A Retrospective Study

Author:Hiral N Modi, Avni M Patel, Tapan P Solanki

Keywords:CT pulmonary angiography (CTPA), Pulmonary Embolism (PE), D-dimer, CRP, CBC, COVID-19.

Type:Original Article

Abstract:"Introduction: Pulmonary thrombosis is one of the known complications of COVID-19 infection. We aimed to assess the incidence of PE in patients with COVID-19 infection and to evaluate the relationship between the CT severity of the disease and the laboratory parameters with the incidence of PE. We also evaluate effect of PE in patients survival. This was a retrospective study conducted on 130 patients with COVID-19 pneumonia infection proved positive by RT- PCR test who underwent CT Pulmonary angiography (CTPA) with a calculation of the CT severity of COVID-19 infection. Available patient’s complaint and laboratory data at the time of CTPA were correlated with presence of PE and outcome of the patients diagnosed with PE during hospital stay. Methods: CTPA was performed on 128 slice PHILIPS CT Scanner machine on 130 patients from DECEMBER 2020 to APRIL 2021 in our SVP Hospital, NHLMMC, Ahmedabad. No age and gender bias were followed. Results: 45 patients (34%) showed positive PE with the median time for the incidence of PE which was 12 days after onset of the disease. No significant correlation was found between the incidence of PE and the patients’ age, sex and inflammatory markers. A statistically significant correlation was found between the incidence of PE and clinical findings including progressive dyspnoea and haemoptysis. Incidence of pulmonary thrombo-embolism increased with rising D-dimer level as well as the moderate to severe CTSI score. There was significant improvement in the patients who were detected early with thrombosis, received early treatment and showed increased rate of survival. Conclusion: Increased CTSI and the rising in D-dimer level are considered the most important parameters suggesting underlying PE in patients with positive COVID-19 infection which is commonly seen during the second week of infection and mandate the use of CT pulmonary angiography to exclude or confirm PE. This may help in improving the management of COVID-19 infection and increased survival of the patients."

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