CT features of pulmonary embolism in patients with COVID-19 pneumonia

OBJECTIVE: The aim of this study was to describe the Computed Tomogra-phy (CT) features of pulmonary embolism in pa-tients hospitalized for acute COVID-19 pneumo-nia and to evaluate the prognostic significance of these features.PATIENTS AND METHODS: This retrospec-tive study included 110 consecutive patients who were hospitalized for acute COVID-19 pneumonia and underwent pulmonary com-puted tomography angiography (BTPA) on the basis of clinical suspicion. The diagnosis of COVID-19 infection was determined by CT find-ings typical of COVID-19 pneumonia and/or a positive result of a reverse transcriptase-poly-merase chain reaction test.RESULTS: Of the 110 patients, 30 (27.3%) had acute pulmonary embolism and 71 (64.5%) had CT features of chronic pulmonary embolism. Of the 14 (12.7%) patients who died despite receiv-ing therapeutic doses of heparin, 13 (92.9%) had CT features of chronic pulmonary embolism and 1 (7.1%) of acute pulmonary embolism. CT features of chronic pulmonary embolism were more com-mon in deceased patients than in surviving pa-tients (92.9% vs. 60.4%, p=0.01, respectively). Low oxygen saturation and high urine microalbumin creatinine ratio at admission in COVID-19 patients are important determinants of mortality after ad-justing for sex and age in logistic procedures.CONCLUSIONS: CT features of chronic pul-monary embolism are common in COVID-19 pa-tients undergoing Computed Tomography Pul-monary Angiography (CTPA) in the hospital. The coexistence of albuminuria, low oxygen satura-tion and CT features of chronic pulmonary em-bolism at admission in COVID-19 patients may herald fatal outcomes.