Pulmonary Embolism in COVID-19 Patients: Awareness of an Increased Prevalence

Julien Poissy, Julien Goutay, Morgan Caplan, Erika Parmentier, Thibault Duburcq, Fanny Lassalle, Emmanuelle Jeanpierre, Antoine Rauch, Julien Labreuche, Sophie Susen, and on behalf of the Lille ICU Haemostasis COVID-19 group

We report a case-series of COVID-19 patients with pulmonary embolism (PE) in our institution. Lille University Hospital is the tertiary care center for the North-of-France, the 2nd French region in population density (189 p/km2), also considered as a “metabolic” area with high number of overweight patients. The study was approved by the Institutional data protection authority of Lille University Hospital.

Among the 107 first consecutive confirmed COVID-19 patients admitted in ICU for pneumonia from Feb 27th to March 31th, we noticed an unexpected high number of PE during their stay in ICU, 22(20.6%) at the time of analysis (April 9th), within a median time from ICU admission of 6 days (range 1 to 18 days). To determine whether this represents an increase in the expected incidence of PE over a similar time interval, we analyzed the files of 196 patients hospitalized in our ICU during the same time interval in 2019. Despite a similar severity score at entrance in ICU, the frequency of PE in our COVID-19 series was twice higher than the frequency we found in this control period, (20.6% vs 6.1%; absolute increase risk of 14.4%, 95%CI 6.1 to 22.8%). It was also twice higher than the 7.5% frequency of PE in the 40 Influenza ICU patients admitted between 1stJanuary to 31thDecember 2019 (3PE, absolute increase risk 13.1%, 95%CI 1.9 to 24.3%).

Keywords: COVID-19; thromboprophylaxis.

Circulation. 2020 Apr 24.
doi: 10.1161/CIRCULATIONAHA.120.047430.
Originally published 24 Apr 2020