Association Between Pulmonary Embolism and COVID‐19 in Emergency Department Patients Undergoing Computed Tomography Pulmonary Angiogram: The PEPCOV International Retrospective Study - Université Paris Cité Accéder directement au contenu
Article Dans Une Revue Academic Emergency Medicine Année : 2020

Association Between Pulmonary Embolism and COVID‐19 in Emergency Department Patients Undergoing Computed Tomography Pulmonary Angiogram: The PEPCOV International Retrospective Study

1 CHU Pitié-Salpêtrière [AP-HP]
2 SU FM - Sorbonne Université - Faculté de Médecine
3 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
4 Hospital Clínic de Barcelona [Catalonia, Spain]
5 ASST Papa Giovanni XXIII [Bergamo, Italy]
6 UdeS - Université de Sherbrooke
7 HEGP - Hôpital Européen Georges Pompidou [APHP]
8 Cliniques Universitaires Saint-Luc [Bruxelles]
9 UCL - Université Catholique de Louvain = Catholic University of Louvain
10 UC - Pontificia Universidad Católica de Chile
11 Hôpital Ambroise Paré [AP-HP]
12 OPTeN (UMR_S 1144 / U1144) - Optimisation thérapeutique en Neuropsychopharmacologie
13 SAMU 93 [Bobigny]
14 MASCOT (UMR_S_942 / U942) - Marqueurs cardiovasculaires en situation de stress
15 Hôpital Beaujon
16 Service de médecine d'urgence [CHU Cochin]
17 Universidad de Alicante
18 IMIM-Hospital del Mar
19 Hôpital Louis Mourier - AP-HP [Colombes]
20 Hôpital Lariboisière-Fernand-Widal [APHP]
21 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
22 CIC - Centre d'investigation clinique [Nancy]
23 Service des Urgences [CHU Nantes]
24 MiHAR - Microbiotes, Hôtes, Antibiotiques et Résistances bactériennes (MiHAR)
25 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
26 CHU - Hôpital Pasteur [Nice]
27 Services des Urgences [CHU Rouen]
28 CHU Saint-Antoine [AP-HP]
29 AP-HP - Hopital Saint-Louis [AP-HP]
30 HUS - Les Hôpitaux Universitaires de Strasbourg
31 FMTS - Fédération de Médecine Translationnelle de Strasbourg
32 NanoRegMed - Nanomédecine Régénérative
33 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
34 LIB - Laboratoire d'Imagerie Biomédicale [Paris]
35 Barts Health NHS Trust [London, UK]
Marine Cachanado
Ben Bloom

Résumé

Background: There have been reports of procoagulant activity in patients with COVID-19. Whether there is an association between pulmonary embolism (PE) and COVID-19 in the emergency department (ED) is unknown. The aim of this study was to assess whether COVID-19 is associated with PE in ED patients who underwent a computed tomographic pulmonary angiogram (CTPA).Methods: A retrospective study in 26 EDs from six countries. ED patients in whom a CTPA was performed for suspected PE during a 2-month period covering the pandemic peak. The primary endpoint was the occurrence of a PE on CTPA. COVID-19 was diagnosed in the ED either on CT or reverse transcriptase-polymerase chain reaction. A multivariable binary logistic regression was built to adjust with other variables known to be associated with PE. A sensitivity analysis was performed in patients included during the pandemic period.Results: A total of 3,358 patients were included, of whom 105 were excluded because COVID-19 status was unknown, leaving 3,253 for analysis. Among them, 974 (30%) were diagnosed with COVID-19. Mean (±SD) age was 61 (±19) years and 52% were women. A PE was diagnosed on CTPA in 500 patients (15%). The risk of PE was similar between COVID-19 patients and others (15% in both groups). In the multivariable binary logistic regression model, COVID-19 was not associated with higher risk of PE (adjusted odds ratio = 0.98, 95% confidence interval = 0.76 to 1.26). There was no association when limited to patients in the pandemic period.Conclusion: In ED patients who underwent CTPA for suspected PE, COVID-19 was not associated with an increased probability of PE diagnosis. These results were also valid when limited to the pandemic period. However, these results may not apply to patients with suspected COVID-19 in general.
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Dates et versions

hal-02948943 , version 1 (25-09-2020)

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Yonathan Freund, Marie Drogrey, Òscar Miró, Alessio Marra, Anne-Laure Féral-Pierssens, et al.. Association Between Pulmonary Embolism and COVID‐19 in Emergency Department Patients Undergoing Computed Tomography Pulmonary Angiogram: The PEPCOV International Retrospective Study. Academic Emergency Medicine, 2020, 27 (9), pp.811-820. ⟨10.1111/acem.14096⟩. ⟨hal-02948943⟩
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