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White blood count, D-dimers, and ferritin levels as predictive factors of pulmonary embolism suspected upon admission in noncritically ill COVID-19 patients: The French multicenter CLOTVID retrospective study #MMPMID34288162
Galland J; Thoreau B; Delrue M; Neuwirth M; Stepanian A; Chauvin A; Dellal A; Nallet O; Roriz M; Devaux M; London J; Martin-Lecamp G; Froissart A; Arab N; Ferron B; Groff MH; Queyrel V; Lorut C; Regard L; Berthoux E; Bayer G; Comarmond C; Lioger B; Mekinian A; Szwebel TA; Sene T; Amador-Boreiro B; Mangin O; Sellier PO; Mouly S; Kevorkian JP; Siguret V; Vodovar D; Sene D
Eur J Haematol 2021[Aug]; 107 (2): 190-201 PMID34288162show ga
BACKGROUND: A high prevalence of pulmonary embolism (PE) has been described during COVID-19. Our aim was to identify predictive factors of PE in non-ICU hospitalized COVID-19 patients. METHODS: Data and outcomes were collected upon admission during a French multicenter retrospective study, including patients hospitalized for COVID-19, with a CT pulmonary angiography (CTPA) performed in the emergency department for suspected PE. Predictive factors significantly associated with PE were identified through a multivariate regression model. RESULTS: A total of 88 patients (median [IQR] age of 68 years [60-78]) were analyzed. Based on CTPA, 47 (53.4%) patients were diagnosed with PE, and 41 were not. D-dimer >/=3000 ng/mL (OR 8.2 [95% CI] 1.3-74.2, sensitivity (Se) 0.84, specificity (Sp) 0.78, P = .03), white blood count (WBC) >/=12.0 G/L (29.5 [2.3-1221.2], Se 0.47, Sp 0.92, P = .02), and ferritin >/=480 microg/L (17.0 [1.7-553.3], Se 0.96, Sp 0.44, P = .03) were independently associated with the PE diagnosis. The presence of the double criterion D-dimer >/=3000 ng/mL and WBC >/=12.0 G/L was greatly associated with PE (OR 21.4 [4.0-397.9], P = .004). CONCLUSION: The white blood count, the D-dimer and ferritin levels could be used as an indication for CTPA to confirm PE on admission in non-ICU COVID-19 patients.