In a new study, researchers found that early diagnosis of a life-threatening blood clot in the lungs led to swifter treatment intervention in COVID-19 patients.
The research was conducted by a team at Henry Ford Health System in Detroit
The team found that 51% of patients found to have a pulmonary embolism or PE, were diagnosed in the Emergency Department, the entry point for patients being admitted to the hospital.
In Europe, research has shown that most cases of PE were diagnosed in patients admitted to the intensive care unit after being on a ventilator for several days.
In the current study, the researchers say 72% of PE diagnoses were in patients who did not require “ICU-level care,” suggesting that timely diagnosis and use of blood thinners could have played a role in the treatment process.
Based on the study, early detection of PE could further enhance and optimize treatment for patients first presenting in the Emergency Department.
The team advises clinicians to think of PE as an additional complication early on during the admission of patients whose symptoms and lab results point to that condition.
They also say a timely pulmonary CT angiography made the difference in the PE diagnosis. They recommend CT angiography because a traditional CT scan may not pick up the blood clot.
In addition to the early detection finding, other key highlights emerged from the retrospective study of 328 COVID-19 patients who underwent a pulmonary CT angiography between March 16 and April 18 at Henry Ford’s acute care hospitals: 22% of patients were found to have a pulmonary embolism.
Patients with a BMI (body mass index) of 30 or higher are nearly three times more at risk for developing a pulmonary embolism. The ideal BMI for adults is 18.5 – 24.9.
Patients on statin therapy prior to admission were less likely to develop a pulmonary embolism.
Increased D-dimer and C-reactive protein lab markers, in conjunction with a rising oxygen requirement, may be a predictor of a pulmonary embolism, even when patients are receiving preventive blood thinners.
These findings suggest that patients who test positive for COVID-19 should be started on preventive blood thinners early on in their treatment and that the need for CT angiography be assessed on a case by case basis to look for blood clots.
One author of the study is Pallavi Bhargava, M.D., an infectious disease physician.
The study is published in Radiology.
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