The Effect of a Pandemic on Computed Tomography Pulmonary Angiography Results and Utilize in the Emergency Department

Yıl 2022, Cilt: 12 Sayı: 2, 280 - 284, 30.06.2022

Kadir Küçükceran Mustafa Kürşat Ayrancı

https://doi.org/10.33808/clinexphealthsci.994118

Cited By: 1

Öz

Objective: The incidence of pulmonary embolism (PE) increases with COVID-19. With the pandemic, changes occur in the utilization of computed tomography pulmonary angiography (CTPA), which we use in the diagnosis of PE. In our study, we investigated the impact of the pandemic on the utilized and result of CTPA.
Methods: Patients over the age of 18 who applied to the emergency department between 01.03.2019 and 28.02.2021 and underwent CTPA was included in this retrospective study. Patients were separated to two groups based on the date of the first case. CTPA result and Polymerase chain reaction (PCR) positivity status were recorded. Data were compared between groups.
Results: While 757(1.022%) out of 74,063 patients underwent CTPA in the pre-pandemic period, 649(1.430%) out of 45,397 patients underwent CTPA in the during-pandemic period. The PE rate in patients who underwent CTPA in the during-pandemic period was statistically significantly
higher compared to the pre-pandemic period (pre-pandemic: 89(11.9%), during-pandemic: 122(19%), p<0.001). In the during-pandemic period, there was no statistically significant difference in the rate of PCR positivity in any time in patients with PE detected as a result of CTPA compared to patients without PE (PE: 14(11.5%), non-PE: 54(10.4%), p=0.725).
Conclusion: Higher rate of CTPA shoot was obtained in the during-pandemic period compared to the pre-pandemic period. Additionally, the rate of PE detection among patients who underwent CTPA was statistically significantly higher in the during-pandemic period compared to the pre-pandemic period.

Anahtar Kelimeler

COVID-19, Pulmonary embolism, Computed Tomography Angiography, Emergency Department

Kaynakça

• [1] Mawaddah A, Genden HS, Lum SG, Marina MB. Upper respiratory tract sampling in COVID-19. Malays J Pathol. 2020;42(1):23-35.
• [2] Tekin E, Bayraktar M, Gür A, Ozlu İ. Investigation of the usability of CT in clinical decision making by comparing COVID-19 positive and probable patients diagnosed according to CT imaging findings. Duzce Medical Journal. 2021; 23(2): 205-210.
• [3] Filippi L, Sartori M, Facci M, Trentin M, Armani A, Guadagnin ML, Prandoni P. Pulmonary embolism in patients with COVID-19 pneumonia: When we have to search for it? Thromb Res. 2021;206(10):29-32.
• [4] Kwee RM, Adams HJ, Kwee TC. Pulmonary embolism in patients with COVID-19 and value of D-dimer assessment: a meta-analysis. Eur Radiol. 2021;31(11):8168-8186.
• [5] Lax SF, Skok K, Zechner P, Kessler HH, Kaufmann N, Koelblinger C, Vander K, Bargfrieder U, Trauner M.. Pulmonary arterial thrombosis in COVID-19 with fatal outcome: results from a prospective, single-center, clinicopathologic case series. Ann Intern Med. 2020;173(5):350-361.
• [6] Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, Huisman MV, Humbert M, Jennings CS, Jiménez D, Kucher N, Lang IM, Lankeit M, Lorusso R, Mazzolai L, Meneveau N, Ní Áinle F, Prandoni P, Pruszczyk P, Righini M, Torbicki A, Van Belle E, Zamorano JL; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603.
• [7] Möckel M, Bachmann U, Behringer W, Pfäfflin F, Stegemann MS. How emergency departments prepare for virus disease outbreaks like COVID-19. Eur J Emerg Med. 2020;27(3):161- 162.
• [8] Agarwal M, Udare A, Patlas M, Ramonas M, Alaref AA, Rozenberg R, Ly DL, Golev DS, Mascola K, van der Pol CB. Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study. CMAJ Open. 2020;8(3):568-576.
• [9] Watchmaker JM, Goldman DT, Lee JY, Choi S, Mills AC, Toussie D, Finkelstein M, Sher AR, Jacobi AH, Bernheim AM, Chung MS, Eber CD, Lookstein RA. Increased incidence of acute pulmonary embolism in emergency department patients during the COVID-19 pandemic. Acad Emerg Med. 2020;27(12):1340- 1343.
• [10] Finn MT, Gogia S, Ingrassia JJ, Cohen M, Madhavan MV, Nabavi Nouri S, Brailovsky Y, Masoumi A, Fried JA, Uriel N, Agerstrand CI, Eisenberger A, Einstein AJ, Brodie D, B Rosenzweig E, Leon MB, Takeda K, Pucillo A, Green P, Kirtane AJ, Parikh SA, Sethi SS. Pulmonary embolism response team utilization during the COVID-19 pandemic. Vasc Med. 2021;26(4):426-433.
• [11] Gerotziafas GT, Catalano M, Colgan MP, Pecsvarady Z, Wautrecht JC, Fazeli B, et al. Guidance for the management of patients with vascular disease or cardiovascular risk factors and COVID-19: position paper from VAS-European Independent Foundation in Angiology/Vascular Medicine. Thromb Haemost. 2020;120(12):1597-1628.
• [12] Suh YJ, Hong H, Ohana M, Bompard F, Revel MP, Valle C, Gervaise A, Poissy J, et al. Pulmonary embolism and deep vein thrombosis in COVID-19: a systematic review and meta-analysis. Radiology. 2021;298(2):70-80.
• [13] Espallargas I, Rodríguez Sevilla JJ, Rodríguez Chiaradía DA, Salar A, et al. CT imaging of pulmonary embolism in patients with COVID-19 pneumonia: a retrospective analysis. Eur Radiol. 2021;31(4):1915-1922.
• [14] Freund Y, Drogrey M, Miró Ò, Marra A, Féral-Pierssens AL, Penaloza A, Hernandez BAL, Bet al. IMPROVING EMERGENCY CARE FHU Collaborators. Association between pulmonary embolism and COVID-19 in emergency department patients undergoing computed tomography pulmonary angiogram: the PEPCOV International Retrospective Study. Acad Emerg Med. 2020;27(9):811-820.
• [15] Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J, Gundlapalli AV; National Syndromic Surveillance Program Community of Practice. Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699-704.
• [16] Liao S-C, Shao S-C, Chen Y-T, Chen Y-C, Hung M-J. Incidence and mortality of pulmonary embolism in COVID-19: a systematic review and meta-analysis. Crit Care. 2020;24(1):464-464.