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Pulmonary Thromboembolism (PTE) in Hospitalised Patients with COVID-19: A National Study of Patients Managed in Critical Care and Ward Environments

M. McGettrick1, A. MacLellan1, P. McCaughey1, C. Bagot2, M. Brewis1, N.N Lang3, M. Johnson1, A.C. Church1

1Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital, Glasgow, United Kingdom, 2Department of Haematology, Glasgow Royal Infirmary, Glasgow, United Kingdom, 3College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom

Abstract Number: PB0176

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: Since the emergence of Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) in late December 2019, there has been increasing recognition of the pro-thrombotic risk this virus can cause as part of Coronavirus disease 2019
(Covid-19).

Aims: To assess if the rate of PTE was increased in those with COVID-19 in both critical care and ward patients. 
To assess the effect of right heart strain or requirement for critical care on mortality.

Methods: We reviewed all computed tomography pulmonary angiograms (CTPA) performed in Scotland between 23rd March and 31st May 2020 (1st wave) and identified those inpatients with COVID-19 using either classical radiological appearances, or positive COVID-19 polymerase chain reaction swab.

Results: Right heart strain survival to 90 days.

3401 CTPAs were reviewed. 192 were positive for PTE in patients with evidence of COVID-19 either real-time polymerase chain reaction (RT-PCR) swab positive for SARS-CoV-2 [n=104] or having radiological changes consistent with COVID-19 [n=88]). The total number of hospital admissions in Scotland between 23rd March 2020 and 31st May 2020 with COVID-19 was 5195. The incidence of PTE during this time was 3.7% in all patients admitted to all hospitals in Scotland with COVID-19 during this period. 475 hospitalised patients were managed in critical care (both level 2 and level 3 care), in whom the incidence of PTE was 6% (n=29). 4720 patients required ward based care alone and the incidence of PTE was 3.5% (n=163). This compares to the national pre-Covid rate of 1%. There was increased risk of death with right heart strain (25/52 vs 128/140[p<0.01]) and in critical care (15/29 vs 146/163[p<0.01]).

Conclusions: In this national study, we have demonstrated an increased risk of pulmonary thromboembolism in both critical care and ward based environments.

To cite this abstract in AMA style:

McGettrick M, MacLellan A, McCaughey P, Bagot C, Brewis M, N Lang N, Johnson M, Church AC. Pulmonary Thromboembolism (PTE) in Hospitalised Patients with COVID-19: A National Study of Patients Managed in Critical Care and Ward Environments [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/pulmonary-thromboembolism-pte-in-hospitalised-patients-with-covid-19-a-national-study-of-patients-managed-in-critical-care-and-ward-environments/. Accessed September 29, 2023.

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