This is a single-center observational retrospective study that included 29 consecutive COVID-19 patients admitted to the San Matteo Hospital Foundation between February and May 2020, with a diagnosis of PE, and a control population of 23 non-COVID-19 patients admitted at our hospital during the same time lapse in 2019. The aim of our exploratory study was to assess the diagnostic delay of PE in COVID-19 patients, and to identify potential associations between patient- or physician-related variables and the delay. There are no studies assessing the impact of diagnostic delay on COVID-19 related PE. Pulmonary embolism (PE) is a frequent, life-threatening COVID-19 complication, whose diagnosis can be challenging because of its non-specific symptoms. Further research could determine additional nuance in D-dimer as a tool to work up suspected VTE. Among those in the highest D-dimer category, > 3,999 ng/mL, over half of patients were VTE positive. More than 50% of those patients were VTE positive.Ĭonclusions Increasing D-dimer values predict increased likelihood of being found VTE positive in this patient population. Higher D-dimer values in both groups were associated with higher likelihood of subsequent VTE diagnosis, with D-dimer values > 3,999 ng/mL in both groups having the highest incidence of VTE. We evaluated 1,834 patients for suspected pulmonary embolism (PE), with 108 (5.9%) PE positive. Results We evaluated 1,752 patients for suspected deep vein thrombosis (DVT), with 191 (10.4%) DVT positive. D-dimer values' bins were evaluated using a logistic regression model. Imaging was evaluated by board-certified radiologists in real time. Advanced imaging including ultrasound, computed tomography (CT) pulmonary angiography, and ventilation/perfusion scanning was obtained at the discretion of the treating physicians. Demographic and clinical data were collected in a structured manner. Methods We conducted a secondary analysis of a multinational, prospective observational study of low- to intermediate-risk adult patients presenting to the emergency department with suspicion of VTE. We hypothesized that higher D-dimer values predict a higher likelihood of subsequent VTE diagnosis. We compared D-dimer levels in patients suspected of having VTE. The assay is primarily used to determine whether to proceed with radiographic imaging. Objectives In patients with suspected venous thromboembolism (VTE), the D-dimer assay is commonly utilized as part of the workup.
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