Evaluation of Pulmonary Thromboembolism Cases Associated with COVID-19 Infection

Nevra Güllü Arslan

Article Details

Evaluation of Pulmonary Thromboembolism Cases Associated with COVID-19 Infection

Authors:

Nevra Güllü Arslan

Publisher:

Izmir Katip Celebi University

Main Topics:

Sağlık Kurumları Yönetimi

Journal:

İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi Vol.8 Issue 1, pp.15-18

Document Type:

Article

Publication Date:

1/2023

Document Language:

Turkish

Document ID (Org No.):

2001283453

pISSN:

2458-9799

Keywords:

Abstract:

 Objective: COVID-19 related hypercoagulability causes endothelial dysfunction, disseminated intravascular coagulopathy, and death especially in intensive care patients. However, this situation may continue throughout recovery, and may present as predisposition of thrombosis in future. In this study, it was aimed to evaluate the cases who were diagnosed with COVID-19 and developed pulmonary thromboembolism in early and late stages. Materials and Methods: 35 patients diagnosed with COVID-19 and pulmonary thromboembolism between March 2020 -June 2021 were examined retrospectively. Demographic data of patients, time period of pulmonary thromboembolism diagnosis, d-dimer levels, echocardiography findings, imaging methods, and survival rates were retrospectively analyzed. Results: Mean age of 35 patients was 68,6  17.2. Diagnosis was made with pulmonary tomography angiography in 82.9 of the patients. Survival rate was 77.1 and death was unrelated to embolism severity p0.346. Pulmonary thromboembolism was segmental in 77.1 of the patients. Right heart failure was observed in 28.6 of the patients. There was no statistically significant relationship between d-dimer levels and other variables. 62.9 of cases were diagnosed with acute infection. 14.3 of the cases in post infection first month, 8.6 in second month, 11.4 in third month, and 2.9 in fourth month were diagnosed with pulmonary thromboembolism. Conclusion: COVID-19 related pulmonary thromboembolism was mostly in cytokine storm dominant period. Independence of severity of embolism from mortality suggested pathologies on both sides of alveolocapillary bed. D-dimer levels were not a marker of prognosis. We think that detecting embolism during recovery period demonstrates different predisposing factors causing thrombosis, and necessitates studies with large number of cases regarding continuation of anticoagulantantiaggregant therapy.

 Objective: COVID-19 related hypercoagulability causes endothelial dysfunction, disseminated intravascular coagulopathy, and death especially in intensive care patients. However, this situation may continue throughout recovery, and may present as predisposition of thrombosis in future. In this study, it was aimed to evaluate the cases who were diagnosed with COVID-19 and developed pulmonary thromboembolism in early and late stages. Materials and Methods: 35 patients diagnosed with COVID-19 and pulmonary thromboembolism between March 2020 -June 2021 were examined retrospectively. Demographic data of patients, time period of pulmonary thromboembolism diagnosis, d-dimer levels, echocardiography findings, imaging methods, and survival rates were retrospectively analyzed. Results: Mean age of 35 patients was 68,6  17.2. Diagnosis was made with pulmonary tomography angiography in 82.9 of the patients. Survival rate was 77.1 and death was unrelated to embolism severity p0.346. Pulmonary thromboembolism was segmental in 77.1 of the patients. Right heart failure was observed in 28.6 of the patients. There was no statistically significant relationship between d-dimer levels and other variables. 62.9 of cases were diagnosed with acute infection. 14.3 of the cases in post infection first month, 8.6 in second month, 11.4 in third month, and 2.9 in fourth month were diagnosed with pulmonary thromboembolism. Conclusion: COVID-19 related pulmonary thromboembolism was mostly in cytokine storm dominant period. Independence of severity of embolism from mortality suggested pathologies on both sides of alveolocapillary bed. D-dimer levels were not a marker of prognosis. We think that detecting embolism during recovery period demonstrates different predisposing factors causing thrombosis, and necessitates studies with large number of cases regarding continuation of anticoagulantantiaggregant therapy.

 Objective: COVID-19 related hypercoagulability causes endothelial dysfunction, disseminated intravascular coagulopathy, and death especially in intensive care patients. However, this situation may continue throughout recovery, and may present as predisposition of thrombosis in future. In this study, it was aimed to evaluate the cases who were diagnosed with COVID-19 and developed pulmonary thromboembolism in early and late stages. Materials and Methods: 35 patients diagnosed with COVID-19 and pulmonary thromboembolism between March 2020 -June 2021 were examined retrospectively. Demographic data of patients, time period of pulmonary thromboembolism diagnosis, d-dimer levels, echocardiography findings, imaging methods, and survival rates were retrospectively analyzed. Results: Mean age of 35 patients was 68,6  17.2. Diagnosis was made with pulmonary tomography angiography in 82.9 of the patients. Survival rate was 77.1 and death was unrelated to embolism severity p0.346. Pulmonary thromboembolism was segmental in 77.1 of the patients. Right heart failure was observed in 28.6 of the patients. There was no statistically significant relationship between d-dimer levels and other variables. 62.9 of cases were diagnosed with acute infection. 14.3 of the cases in post infection first month, 8.6 in second month, 11.4 in third month, and 2.9 in fourth month were diagnosed with pulmonary thromboembolism. Conclusion: COVID-19 related pulmonary thromboembolism was mostly in cytokine storm dominant period. Independence of severity of embolism from mortality suggested pathologies on both sides of alveolocapillary bed. D-dimer levels were not a marker of prognosis. We think that detecting embolism during recovery period demonstrates different predisposing factors causing thrombosis, and necessitates studies with large number of cases regarding continuation of anticoagulantantiaggregant therapy.

 Amaç: COVID-19un sebep olduğu hiperkoagülabilite; özellikle yoğun bakım hastalarında endotel disfonksiyonu, dissemine intravasküler koagülopati ve ölüme neden olmaktadır. Ancak iyileşme döneminde de devam edebilen bu durumun, ileri dönemde tromboza yatkınlık olarak karşımıza çıkabileceği öngörülmektedir. Çalışmamızda; Samsun Eğitim Araştırma Hastanesinde COVID-19 tanısı almış, erken ve geç dönemde pulmoner emboli gelişmiş olguların değerlendirmesi hedeflendi. Gereç ve Yöntem: Mart 2020-Haziran 2021 tarihleri arasında, Samsun Eğitim Araştırma Hastanesi veri tabanından COVID-19 ve pulmoner emboli tanısı almış olan 35 hasta incelenmiştir. Hastaların demografik verileri, emboli tanısı aldıkları zaman dilimi, d-dimer düzeyleri, ekokardiyografi bulguları, hangi görüntüleme yöntemi kullanıldığı, sağ kalım durumları retrospektif olarak incelendi. Bulgular: 35 hastanın yaş ortalaması 68,6  17.2 olup, tanı 82,9 n29 pulmoner tomografi anjio ile konulmuştur. Sağ kalım oranı 77.1 n27 olup, ölüm emboli şiddeti ile ilişkisiz bulunmuştur p0,346. 27 hastada 77,1 segmenter, 8 hastada 22,9 submasifmasif emboli saptanmıştır. Ekokardiyografi yapılan hastaların 28.6sında sağ kalp yetmezliği izlenmiştir. D-dimer düzeyi ile diğer hiçbir değişken arasında anlamlı ilişki saptanmamıştır. Olguların 22si 62,9 akut enfeksiyon; 5i 14,3 enfeksiyondan sonraki birinci ayda, 3ü 8,6 ikinci ayda, 4ü 11,4 üçüncü ayda, 1i 2,9 dördüncü ayda emboli tanısı almıştır. Sonuç: Çalışmamızda; COVID-19a bağlı emboli olgularının çoğunlukla sitokin fırtınasının baskın olduğu akut dönemde olduğu izlenmiştir. Ölüm oranlarının embolinin şiddetinden bağımsız olması, alveolokapiller yatağın her iki tarafındaki patolojilerin mortaliteyi birlikte etkilediğini düşündürmüş; d-dimer düzeyleri, hastalığın şiddeti ve prognozu açısından belirteç olmamıştır. İyileşme sürecinde saptanan emboli olgularında; tromboza sebep olan farklı predispozanlar olduğunu düşünmekteyiz;Ayrıca antikoagülan antiagregan tedavinin sürdürülmesine dair daha geniş olgu sayıları ile yapılacak çalışmalar gerekmektedir.

Article Details

Evaluation of Pulmonary Thromboembolism Cases Associated with COVID-19 Infection

Authors:

Nevra Güllü Arslan

Publisher:

Izmir Katip Celebi University

Main Topics:

Sağlık Kurumları Yönetimi

Journal:

İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi Vol.8 Issue 1, pp.15-18

Document Type:

Article

Publication Date:

1/2023

Document Language:

Turkish

Document ID (Org No.):

2001283453

pISSN:

2458-9799

COVID-19

pulmonary thromboembolism

hypercoagulability

post COVID

COVID 19

pulmoner tromboemboli

post COVID

hiperkoagülabilite

COVID-19

pulmonary thromboembolism

hypercoagulability

Issues

Article Details

Authors: Nevra Güllü Arslan

Publisher: Izmir Katip Celebi University

Main Topics: Sağlık Kurumları Yönetimi

Journal: İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi Vol.8 Issue 1, pp.15-18

Document Type: Article

Publication Date: 1/2023

Document Language: Turkish

Document ID (Org No.): 2001283453

pISSN: 2458-9799

Issues

Authors:

Nevra Güllü Arslan

Publisher:

Izmir Katip Celebi University

Main Topics:

Sağlık Kurumları Yönetimi

Journal:

İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi Vol.8 Issue 1, pp.15-18

Document Type:

Article

Publication Date:

1/2023

Document Language:

Turkish

Document ID (Org No.):

2001283453

pISSN:

2458-9799