Covid-19 and pulmonary embolism : A heterogeneous association

Introduction: Covid-19 pneumonia has been shown to be associated with an increased prevalence of pulmonary embolism (PE) and along with it, an expected higher risk of morbidity and mortality. Aim: Identifying risk factors for PE and eventual prognosis relating to these factors. Methods: 139 patients were admitted to the military hospital of Tunis, positive on covid-19 RT-PCR testing, from September 2020 to February 2021. Results: Out of those patients,12 (11.8%) had a pulmonary embolism confirmed by CT-angiography.There was no significant correlation between PE and gender, history of pulmonary disease (asthma and COPD), or cardiovascular risk factors (type-2 diabetes, hypertension, dyslipidemia).There was a statistically significant difference between Hemoglobin serum levels in the PE positive group vs the PE negative group(11,66 g/dL vs 13,01 g/dL, p-value 0,22).This was also the case for prothrombin ratio which was lower in the PE positive group than in the negative group(79,5% vs 90,32%, p-value 0,39).Mean D-dimer, measured on admission, was not significantly higher in the PE positive group (5052 ng/mL) than the PE negative group(2404 ng/mL), similarly to C-reactive protein levels(129,12 mg/L vs 152,7mg/L).No significant correlation was found between PE, fibrinogen and ferritinemia serum levels.On CT-scans, out of 12 patients, 5 had a 25-50% lesion extent,3 had 50-75% and only 1 had >75% while the rest were not siginificant.PE was not associated with a worst outcome:no patients needed optiflow or intubation during admission and there was no significant difference in death between the two groups. Conclusion: These findings give another perspective on PE in the context of covid-19 and emphasize the heterogeneity of its induced coagulopathy.