Murat UĞUR, Taha Yusuf KUZAN, Nurettin YİYİT

Thromboprophylaxis decreases the risk of pulmonary embolism in COVID-19

Aim: Pulmonary embolism caused by micromboli and microthrombuses might be associated with increased mortality and morbidity in Covid-19. Routine thromboprophylaxis application might contribute to clinical recovery by reducing the risk of pulmonary embolism. In this study, the effects of thromboprophylaxis on clinical outcomes were investigated by examining the rates of computed tomographic angiography requests for the differential diagnosis of pulmonary embolism in the patients with Covid-19. Materials and Methods: Patients who underwent computed tomography (CT) between 10 March and 25 May 2020 in our hospital were retrospectively analysed. Patients who received simultaneous PCR tests during CT examination were included in the study. In the follow-up of these patients, rates of pulmonary CT angiography request with the suspicion of pulmonary embolism and it’s were investigated. Results: During the study period, thorax CT was performed in 11142 patients and pulmonary CT angiography was performed in 161 (1.4%) of them. Ninety-nine patients who were performed CT angiography and PCR test during the hospitalization period were included in the study. PCR test was positive in 22% (n = 21) of the patients (22%) and pulmonary embolism was detected in 6 of them (6.3%). PCR test was negative in 74 patients (78%) and 17 (17.9%) had pulmonary embolism. Conclusion: Routine thromboprophylaxis contributes to the treatment of Covid-19 by preventing the development of microthrombosis and thrombotic complications in the respiratory system.

Keywords:

Covid-19 Coronovirus, pumonary embolism, thrombosis,

PDF

___

Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost 2020; 18: 1421-4.
Oudkerk M, Büller HR, Kuijpers D, et al. Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands. Radiology 2020; 297: 216-22.
Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020; 191: 145-7.
Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute pulmonary embolism associated with COVID-19 Pneumonia Detected with Pulmonary CT Angiography. Radiology 2020; 296: E186-E188
Whyte MB, Kelly PA, Gonzalez E, Arya R, Roberts LN. Pulmonary embolism in hospitalised patients with COVID-19. Thromb Res 2020; 195: 95-99.
COVID-19 (SARS-CoV-2 infection) guide. Science Committee Work. Ministriy of Health, Public Health General Directorate. Ankara, April, 2020.
Kuzan TY, Murzoğlu Altıntoprak K, Çiftçi HÖ, et al. A comparison of clinical, laboratory and chest CT findings of laboratory-confirmed and clinically diagnosed COVID-19 patients at first admission. Diagn Interv Radiol. 2020; 10.5152/dir.2020.20270.
Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC State-of-the-Art review. J Am Coll Cardiol 2020; 75: 2950-73.
Liu X, Li Z, Liu S, et al. Potential therapeutic effects of dipyridamole in the severely ill patients with COVID-19. Acta Pharm Sin B 2020; 10: 1205-15.
Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS. Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: Molecular mechanisms and potential therapeutic target. Intensive Care Med 2020; 46: 586-90.
Li T, Lu H, Zhang W. Clinical observation and management of COVID-19 patients. Emerg Microbes Infect 2020; 9: 687-90.
Barnes BJ, Adrover JM, Baxter-Stoltzfus A, et al. Targeting potential drivers of COVID-19: Neutrophil extracellular traps. J Exp Med 2020; 217: e20200652.
Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020; 18: 844-7.
Miesbach W, Makris M. COVID-19: Coagulopathy, risk of thrombosis, and the rationale for anticoagulation. Clin Appl Thromb Hemost 2020; 26: 1076029620938149.
Magro C, Mulvey JJ, Berlin D, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res 2020; 220: 1-13.
Frater JL, Zini G, d’Onofrio G, Rogers HJ. COVID-19 and the clinical hematology laboratory. Int J Lab Hematol. 2020; 42: 11-8.
Wang T, Chen R, Liu C, et al. Attention should be paid to venous thromboembolism prophylaxis in the management of COVID-19. Lancet Haematol 2020; 7: 362–3.