Diagnosis of COVID-19 in Patients with Acute Pulmonary Embolism

Diagnosis of COVID-19 in Patients with Acute Pulmonary Embolism

Ibrahim Koc,¹ Ozlem Yildiz,¹ Mesiha Babalik,¹ Rahime Ozgur Isgbol,¹ Sevda Unalli Ozmen,² Duygu Zeytinoglu,¹ Nazan Nalci Savas,¹ Ilhami Yapici,¹ Halil Celikten,¹ Sedat Demirsoy¹ and Olgun Deniz³

¹Bursa City Hospital, Pulmonary Medicine Clinic, Bursa, Turkey
²Bursa City Hospital, Medical Biochemistry, Bursa, Turkey
³Bursa City Hospital, Geriatrics Medicine Clinic, Bursa, Turkey

Acute pulmonary embolism (PE) and coronavirus disease]2019 (COVID]19) are life-threatening diseases associated with significant morbidity and mortality. Yet little is known about their co-existence. This study explored clinical and laboratory differences between PE patients who tested positive with real]time reverse]transcription polymerase chain reaction (PCR+) and those who tested negative (PCR) for SARS-CoV-2. Also, to determine whether ferritin D-dimer ratio (FDR) and platelet D-dimer ratio (PDR) can be used to predict COVID-19 in patients with PE. Files of 556 patients who underwent a computed tomography pulmonary angography (CTPA) examination were retrospectively investigated. Out of them, 197 were tested positive and 188 negative for SARS-CoV-2. One hundred thirteen patients (57.36%) in the PCR+ group and 113 (60.11%) in the PCR group had a diagnosis of PE. Complaints, respiratory rate, and oxygen saturation level in the blood (SpO₂) were recorded at the first admission. Monocyte and eosinophil levels remained low, whereas FDR and PDR were higher in the PCR+ group. No difference was detected in ferritin, D-dimer levels, comorbidities, SpO₂, and death rates between the two groups. Cough, fever, joint pain, and higher respiratory rate were more common in the PCR+ group. A decrease in white blood cell, monocyte, and eosinophil levels, whereas an increase in FDR and PDR levels may predict COVID-19 in patients with PE. PE patients complaining of cough, fever, and fatigue should undergo PCR testing as common symptoms. COVID-19 does not seem to increase the risk of mortality in patients with PE.

Key words —— COVID-19; eosinophil; ferritin D-dimer ratio; pulmonary embolism

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Tohoku J. Exp. Med., 2023 June, 260(2), 127-133.

Correspondence: Ibrahim Koc, Bursa City Hospital, Pulmonary Medicine Clinic, Dogankoy Street, Nilufer, Bursa 16110, Turkey.

e-mail: ibrahimkoc1981@gmail.com