Características clínicas, factores de riesgo y resultados finales de pacientes con COVID-19 diagnosticados de tromboembolia de pulmón en urgencias

espanolObjetivo. Analizar las caracteristicas clinicas, analiticas, radiologicas y los resultados finales de salud en una cohorte de pacientes con embolia pulmonar (EP) y COVID-19, y compararlas con un grupo de pacientes con EP sin COVID-19. Metodo. Estudio multicentrico, observacional y retrospectivo realizado en cuatro servicios de urgencias hospitalarios (SUH) espanoles del 15 de enero al 15 de abril de 2020. La deteccion de EP se hizo mediante la revision de todas las angiografias por tomografia computarizada (angioTC) pulmonares solicitadas desde los SUH. Se han analizado dos grupos de pacientes con EP, con o sin enfermedad por COVID-19, y se comparan las caracteristicas clinicas, analiticas, radiologicas, antecedentes y comorbilidad, factores de riesgo y resultados finales. Resultados. Se realizaron 399 angioTC y se diagnosticaron 88 EP, 28 (32%) en pacientes con COVID-19. Estos pacientes fueron con mas frecuencia hombres y tenian mas antecedentes de enfermedad tromboembolica previa. No hubo diferencias en la presentacion clinica, caracteristicas analiticas o radiologicas ni en los resultados finales entre ambos grupos. La mortalidad intrahospitalaria fue del 7% (2 casos) en pacientes COVID y del 17% (10 casos) en pacientes sin COVID (OR de muerte en pacientes COVID con EP: 0,38, IC 95%: 0,08-1,89). Conclusiones. No se han observado diferencias clinicamente relevantes en las caracteristicas clinicas, analiticas, radiologicas y los resultados finales de salud en una cohorte de pacientes con EP y COVID-19 respecto a los pacientes con EP sin esta enfermedad atendidos en los SUH. EnglishObjective. To analyze clinical, laboratory, and radiologic findings and final health outcomes in patients with pulmonary embolism and coronavirus disease 2019 (COVID-19). To compare them to findings and outcomes in patients with pulmonary embolism without COVID-19. Methods. Multicenter, observational, retrospective study in 4 Spanish hospital emergency departments (EDs) from January 15 to April 15, 2020. Cases were located by reviewing all ED requests for pulmonary computed tomography angiography (CTA) procedures. Clinical, laboratory, and radiologic findings; medical histories and comorbidity; risk factors; and outcomes were compared between the 2 groups of patients (with or without COVID-19). Results. A total of 399 CTAs were ordered; 88 pulmonary embolisms were diagnosed, 28 of them (32%) in patients with COVID-19. This group had more men, and a history of thromboembolic disease was more common. We found no between-group differences in clinical presentation, laboratory, or radiologic findings; nor were there differences in final outcomes. In-hospital mortality was 7% (2 cases) in patients with COVID-19 and 17% (10 cases) in patients without the virus (odds ratio for death in patients with pulmonary embolism and COVID-19, 0.38; 95% CI, 0.08–1.89). Conclusions. We found no clinically important differences in the clinical, laboratory, or radiologic findings between patients with or without COVID-19 who were treated for pulmonary embolism in our hospital EDs. Final outcomes also did not differ