부산대학교 도서관

Introduction: While pulmonary embolism(PE) appears to be a major issue in Covid-19, data remain sparse.Hypothesis: We aimed to describe the risk factors and baseline characteristics of patients with PE in a cohort of Covid-19 patients.Methods: In a retrospective multicentric observational study, we included consecutive hospitalised patients for Covid-19. Patients without computed tomography pulmonary angiography (CTPA)-proven PE diagnosis and those who were directly admitted to an intensive care unit(ICU) were excluded.Results: Among 1,240 patients (58.1% men, mean age 64±17 years), 103 (8.3%) patients had PE confirmed by CTPA. The ICU transfer and mechanical ventilation were significantly higher in the PE group (for both p<0.001). In an univariable analysis, traditional venous thromboembolic risk factors were not associated with PE (p>0.05), while patients under therapeutic-dose anticoagulation before hospitalisation or prophylaxis-dose anticoagulation introduced during hospitalisation had lower PE occurrence (OR 0.40, 95%CI(0.14-0.91); p=0.04 and OR 0.11, 95%CI(0.06-0.18); p<0.001, respectively). In a multivariable analysis, the following variables, also statistically significant in univariable analysis, were associated with PE: male gender (OR 1.03, 95%CI(1.003-1.069); p=0.04), anticoagulation with prophylaxis-dose (OR 0.83, 95%CI(0.79-0.85), p<0.001) or therapeutic-dose (OR 0.87, 95%CI(0.82-0.92), p<0.001), C-reactive protein (OR 1.03, 95%CI(1.01-1.04), p=0.001) and time from symptom onset to hospitalisation (OR 1.02, 95%CI(1.006-1.038), p=0.002).Conclusions: Pulmonary embolism risk factors in Covid-19 context do not include traditional thromboembolic risk factors but rather independent clinical and biological findings at admission, including a major contribution to inflammation.