It is well known that hospitalization can be a stressful and difficult experience for patients and their loved ones. One of the many concerns that can arise during a hospital stay is the potential for developing a pressure ulcer, also called a “decubitus ulcer” or “bed sore.” A pressure ulcer is an area of skin that breaks down and forms an open wound when there is prolonged pressure on the skin. Pressure ulcers are a serious complication for hospitalized patients and can lead to longer hospital stays, increased pain, and even death. Although the exact prevalence of pressure ulcers is not known, it is estimated that around 10% of hospitalized patients will develop a pressure ulcer during their stay.
Can Covid-19 Cause Pulmonary Embolism?
There is no definitive answer to this question as the research is still ongoing. However, there is some evidence to suggest that Covid-19 can cause pulmonary embolism. A study published in the journal Radiology found that out of a group of patients who had been hospitalized with Covid-19, 3% developed pulmonary embolism. While this is a small percentage, it is still significant and further research is needed to determine the true risk of this complication.
Approximately 25% of hospitalized COVID-19 patients who had chest CT or scintigraphy discovered pulmonary embolism. It was expected that PE sensitivity would be 100% [8.761 nmol/L] if the d-dimer level was 1600 ng/mL or higher. Men had a higher PE rate than smokers (OR, 1.7; P =.01) but this did not differ significantly from those in the ICU or out. The purpose of this study is to examine the relationship between right-sided heart strain and clot burden using d-dimer level data. We evaluated patients admitted to four hospitals for COVID-19 and developed a predictive model to predict who would develop PE. Data from a variety of sources, including RT-PCR diagnosis dates and demographic and clinical information, was obtained during the study. During a breath hold, CT pulmonary angiography was performed with ioversol (Optiray 350; Mallinckrodt) or iohexol (Omnipaque 300) injections, injecting 70–100 mL of either.
A smooth contrast enhancement of the pulmonary artery was performed using a bit of timing. It was determined based on echocardiographic findings obtained within 1 day of the CT or perfusion scintigraphy of patients in whom such findings were available based on the right-sided heart strain. The study sample was randomly allocated to a training set and an internal validation test set to complete the training. We used a random forest model to predict acute PE after training on a balanced training set. We did not include five patients who had perfusion scintigraphy in this analysis because we needed to maintain consistency with our method of outcome detection. Between March 3 and June 5, 2020, a total of 335 SARS-CoV-2 RT-PCR tests were performed at four hospitals, with a positive result for 8460 patients. A total of 4131 patients were admitted for CT pulmonary angiography or perfusion scintigraphy, accounting for the majority of these patients.
PE cases in these patients accounted for 25% (102 of 413; 95% CI: 21, 29). ( Tables 1, 2, 3). PE had significantly higher levels of alanine aminotransferase, lactate dehydrogenase, ferritin, d-dimer, and interleukin-6, as well as lower oxygen saturation (Tables 1, 2, 3). Acute deep vein thrombosis was more common in patients with PE-positive results. Patients with right-sided heart strain had a higher embolic burden according to Mann-Whitney U tests. Table E2 (online) contains a sensitivity analysis for the final random forest model generated on the test set. The ideal cutoff for d-dimer was 1600ng/mL (8.761 nmol/L), with the Youden index used in the entire sample.
In this multicenter study of 413 patients hospitalized with COVID-19 and suspected of having a pulmonary embolism, PE was discovered in 25% of patients at 95% CI: 21, 29). In comparison to overall PE incidence rates of 17.6% (ca 95% CI: 12.3, 23.5), COVID-19 hospitalized patients have an incidence rate of 25%. PE was not found to be significantly higher in patients in the intensive care unit. The small sample size of the studies analyzed by Liu et al indicates that the PE incidence reported by them is large. Previously, there have been reports of right ventricular systolic dysfunction in patients who have COVID-19 and PE without PE due to the release of vasoactive mediators. When the right side of the heart is working harder, it is associated with PE and syncope. It was unable to collect retrospective data in this study.
The following are contributions from S.R. Behzadi, J.K. Bamashmo, H.A. Rizadi, and S.I. R. who did not disclose any relevant relationships. The Duke Cancer Institute received in-kind research support from Siemens Healthineers for MRI development, as well as ad hoc consulting consideration from Promaxo and the provision of a honorarium for speaking at a prostate cancer research institute patient support group. The Society of Interventional Radiology resident Fellows and Students International Outreach Committee are both active members of the A.M. The Clinical and Translational Science Center (grant UL1 TR000457) and the Joint Clinical Trial Office are both part of the New York Presbyterian Hospital and Weill Cornell Medical College.
