Article Figures & Data
Figures
- FIGURE 1.
Diagnostic flowchart in 17 COV+ (A) and 36 COV− (B) patients. Arrows refer to flow of patients, whereas adjacent numbers indicate number of patients involved. Blue arrows indicate negative test result; red arrows signify positive test result. AC = anticoagulation; CT = CTPA; IA = interventional angiography; rx = therapy; US = leg Doppler ultrasound.
- FIGURE 2.
Key images of 4 representative patients. All chest radiographs demonstrate absence of significant opacities. (A) A 44-y-old woman, COV+ by polymerase chain reaction testing. No defects were noted on perfusion scintigraphy. Patient was not anticoagulated and was discharged without complication. (B) A 35-y-old woman, COV− by polymerase chain reaction testing. Well-defined segmental perfusion defect in superior lingula was indeterminate for PE. CTPA demonstrated normal pulmonary arterial perfusion; patient was discharged home without anticoagulation treatment. (C) A 43-y-old man, COV+ by polymerase chain reaction testing, with elevated D-dimer (19.7 μg/mL). Multiple bilateral segmental defects, especially involving right lung, were indeterminate for PE. Patient subsequently was discharged on anticoagulation treatment. (D) A 59-y-old woman, COV− by polymerase chain reaction testing. There is global decrease in perfusion of right lung, indeterminate for PE. CTPA demonstrated normal pulmonary arterial perfusion; patient was discharged home without anticoagulation treatment.
Tables
Parameter All patients COV+ COV− P COVID-19 status (n) Total 53 17 36 — By polymerase chain reaction testing 46 13 33 — By clinical assessment 7 4 3 — Mean age ± SD (y) 49.0 ± 16.2 47.5 ± 17.2 49.8 ± 15.9 0.68 Females (n) 39 (74%) 10 (59) 29 (81) 0.11 Patients with serum creatinine ≥ 1.5 mg/dL (n) 19 (36%) 6 (35%) 13 (36%) 1 Patients with history of contrast allergy (n) 3 (6%) 1 (6%) 2 (6%) 1 Median D-dimer values (μg/mL)* 1.18 (IQR = 1.7) 1.34 (IQR = 2.3) 1.17 (IQR = 1.5) 0.66 Parenchymal findings on prior chest radiography (n) 13 (25%) 7 (41%) 6 (17%) 0.08 Patients with prior negative Doppler US (n) 8 2 6† — Patients with prior positive Doppler US (n) 2 0 2 — Patients with prior nondiagnostic CTPA (n) 2 — 2† — Patients with ≥1 perfusion defects (n) 11 (21%) 3 (18%) 8 (22%) 1 Follow-up examinations on patients with ≥1 perfusion defects (n) 6/11 (55%) 0/3 (0%) 6/8 (75%) 0.06 *Reference value, ≤0.50 μg/mL. P values for D-dimer are based on Wilcoxon rank-sum testing.
↵†One patient had both negative Doppler findings and nondiagnostic CTPA.
IQR = interquartile range.
P values are for differences between COV+ and COV− subgroups.
