Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/250470 |
Resumo: | Background D-dimer levels are significantly higher in COVID-19 patients with Pulmonary Thromboembolism (PTE) as compared to those without PTE, but its clinical utility is still uncertain. Purpose To determine the D-dimer performance for ruling out PTE in patients with COVID-19. We also assessed clinical and laboratory factors associated with the presence of PTE on CT Pulmonary Angiogram (CTPA). Methods Retrospective study involving all patients who presented at a tertiary care hospital from March 2020 to May 2021 with severe acute respiratory syndrome from COVID-19, who underwent CTPA and had D-dimer collected within 48 hours from CTPA. The D-dimer ability to classify patients with or without PTE according to CTPA was evaluated. Results A total of 697 patients [382 (54.8%) men; mean (SD) age, 59 (20.5) years] were included, of which 71.5% required intensive care admission, 32.4% had PTE, and 35.6% died during hospitalization. PTE was independently associated with mortality [42.5% vs. 32.3%; p = 0.038]. D-dimer levels were higher in patients with PTE [9.1 (3.9; 20) vs. 2.3 (1.2; 5.1); p < 0.001]. Using the D-dimer cutoff of 0.5 μg/mL or above, sensitivity was 98.2% and specificity 5.7%. The 0.3 μg/mL threshold was associated with 100% of sensitivity for the presence of PTE, with which 99.1% of patients had increased values. ROC curve AUC was 0.77, demonstrating moderate discriminative power of D-dimers to detect PTE. Conclusions D-dimer levels are higher among COVID-19 hospitalized patients with PTE as compared to those without PTE and have moderate discriminative power to detect PTE, but its use to exclude PTE in this population may have limited clinical utility. |
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Vivan, Manoela AstolfiRigatti, BrendaCunha, Sainan Voss daFrison, Guilherme CristianettiAntoniazzi, Lucas QuadrosOliveira, Paulo Henrique Kranz deOliveira, João Pedro SouzaFontanari, ClaraSeligman, Beatriz Graeff SantosSeligman, Renato2022-10-27T04:52:15Z20221413-8670http://hdl.handle.net/10183/250470001151630Background D-dimer levels are significantly higher in COVID-19 patients with Pulmonary Thromboembolism (PTE) as compared to those without PTE, but its clinical utility is still uncertain. Purpose To determine the D-dimer performance for ruling out PTE in patients with COVID-19. We also assessed clinical and laboratory factors associated with the presence of PTE on CT Pulmonary Angiogram (CTPA). Methods Retrospective study involving all patients who presented at a tertiary care hospital from March 2020 to May 2021 with severe acute respiratory syndrome from COVID-19, who underwent CTPA and had D-dimer collected within 48 hours from CTPA. The D-dimer ability to classify patients with or without PTE according to CTPA was evaluated. Results A total of 697 patients [382 (54.8%) men; mean (SD) age, 59 (20.5) years] were included, of which 71.5% required intensive care admission, 32.4% had PTE, and 35.6% died during hospitalization. PTE was independently associated with mortality [42.5% vs. 32.3%; p = 0.038]. D-dimer levels were higher in patients with PTE [9.1 (3.9; 20) vs. 2.3 (1.2; 5.1); p < 0.001]. Using the D-dimer cutoff of 0.5 μg/mL or above, sensitivity was 98.2% and specificity 5.7%. The 0.3 μg/mL threshold was associated with 100% of sensitivity for the presence of PTE, with which 99.1% of patients had increased values. ROC curve AUC was 0.77, demonstrating moderate discriminative power of D-dimers to detect PTE. Conclusions D-dimer levels are higher among COVID-19 hospitalized patients with PTE as compared to those without PTE and have moderate discriminative power to detect PTE, but its use to exclude PTE in this population may have limited clinical utility.application/pdfengThe Brazilian journal of infectious diseases. Salvador. Vol. 26, no. 6 (2022), 102702, 9 p.COVID-19Embolia pulmonarDiagnósticoPulmonary embolismD-dimerPulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective studyinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001151630.pdf.txt001151630.pdf.txtExtracted Texttext/plain37580http://www.lume.ufrgs.br/bitstream/10183/250470/2/001151630.pdf.txtc8c38f77ee529014d5c6df49d03babf2MD52ORIGINAL001151630.pdfTexto completo (inglês)application/pdf676345http://www.lume.ufrgs.br/bitstream/10183/250470/1/001151630.pdfd60d770ee1c25608a909004a94198250MD5110183/2504702022-10-28 04:48:14.159099oai:www.lume.ufrgs.br:10183/250470Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2022-10-28T07:48:14Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study |
title |
Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study |
spellingShingle |
Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study Vivan, Manoela Astolfi COVID-19 Embolia pulmonar Diagnóstico Pulmonary embolism D-dimer |
title_short |
Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study |
title_full |
Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study |
title_fullStr |
Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study |
title_full_unstemmed |
Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study |
title_sort |
Pulmonary embolism in patients with COVID-19 and D-dimer diagnostic value : a retrospective study |
author |
Vivan, Manoela Astolfi |
author_facet |
Vivan, Manoela Astolfi Rigatti, Brenda Cunha, Sainan Voss da Frison, Guilherme Cristianetti Antoniazzi, Lucas Quadros Oliveira, Paulo Henrique Kranz de Oliveira, João Pedro Souza Fontanari, Clara Seligman, Beatriz Graeff Santos Seligman, Renato |
author_role |
author |
author2 |
Rigatti, Brenda Cunha, Sainan Voss da Frison, Guilherme Cristianetti Antoniazzi, Lucas Quadros Oliveira, Paulo Henrique Kranz de Oliveira, João Pedro Souza Fontanari, Clara Seligman, Beatriz Graeff Santos Seligman, Renato |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Vivan, Manoela Astolfi Rigatti, Brenda Cunha, Sainan Voss da Frison, Guilherme Cristianetti Antoniazzi, Lucas Quadros Oliveira, Paulo Henrique Kranz de Oliveira, João Pedro Souza Fontanari, Clara Seligman, Beatriz Graeff Santos Seligman, Renato |
dc.subject.por.fl_str_mv |
COVID-19 Embolia pulmonar Diagnóstico |
topic |
COVID-19 Embolia pulmonar Diagnóstico Pulmonary embolism D-dimer |
dc.subject.eng.fl_str_mv |
Pulmonary embolism D-dimer |
description |
Background D-dimer levels are significantly higher in COVID-19 patients with Pulmonary Thromboembolism (PTE) as compared to those without PTE, but its clinical utility is still uncertain. Purpose To determine the D-dimer performance for ruling out PTE in patients with COVID-19. We also assessed clinical and laboratory factors associated with the presence of PTE on CT Pulmonary Angiogram (CTPA). Methods Retrospective study involving all patients who presented at a tertiary care hospital from March 2020 to May 2021 with severe acute respiratory syndrome from COVID-19, who underwent CTPA and had D-dimer collected within 48 hours from CTPA. The D-dimer ability to classify patients with or without PTE according to CTPA was evaluated. Results A total of 697 patients [382 (54.8%) men; mean (SD) age, 59 (20.5) years] were included, of which 71.5% required intensive care admission, 32.4% had PTE, and 35.6% died during hospitalization. PTE was independently associated with mortality [42.5% vs. 32.3%; p = 0.038]. D-dimer levels were higher in patients with PTE [9.1 (3.9; 20) vs. 2.3 (1.2; 5.1); p < 0.001]. Using the D-dimer cutoff of 0.5 μg/mL or above, sensitivity was 98.2% and specificity 5.7%. The 0.3 μg/mL threshold was associated with 100% of sensitivity for the presence of PTE, with which 99.1% of patients had increased values. ROC curve AUC was 0.77, demonstrating moderate discriminative power of D-dimers to detect PTE. Conclusions D-dimer levels are higher among COVID-19 hospitalized patients with PTE as compared to those without PTE and have moderate discriminative power to detect PTE, but its use to exclude PTE in this population may have limited clinical utility. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-10-27T04:52:15Z |
dc.date.issued.fl_str_mv |
2022 |
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info:eu-repo/semantics/article info:eu-repo/semantics/other |
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1413-8670 |
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The Brazilian journal of infectious diseases. Salvador. Vol. 26, no. 6 (2022), 102702, 9 p. |
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