• Davide Ippolito, Teresa Giandola, Cesare Maino, Anna Pecorelli, Carlo Capodaglio, Maria Ragusi, Marco Porta, Davide Gandola, Alessandro Masetto, Silvia Drago, Pietro Allegranza, Rocco Corso, Cammillo Talei Franzesi, and Sandro Sironi.
• Department of Diagnostic Radiology, School of Medicine, University of Milano-Bicocca, H. S. Gerardo, Via Pergolesi 33, 20900, Monza, Milan, Italy.
• Radiol Med. 2021 May 1; 126 (5): 669-678.

PurposeTo analyze pulmonary embolism (PE) on chest computed tomography pulmonary angiography (CTPA) in hospitalized patients affected by SARS-CoV-2, according to the severity of lung disease based both on temporal CT features changes and on CT-severity lung involvement (CT-severity score), along with the support of clinical and laboratory findings.MethodsWe retrospectively enrolled a total of 170 patients with confirmed SARS-CoV-2 infection who underwent CTPA examination for PE suspicion. Pulmonary arteries diameters, right ventricle/left ventricle (RV/LV) ratio, presence, absence, and distribution of PE, pulmonary artery obstructive index (PAO index), and lobe involvement were recorded. All CT scans were reviewed to assess temporal CT changes and the COVID CT-severity score.ResultsA total of 76 out of 170 patients (44.7%) developed PE without having any major risk factors for venous thromboembolism. The most severe pulmonary arteries involvement, expressed in terms of PAO Index, occurred in those patients with markedly elevated D-dimer and C-reactive protein (CRP) values and those patients with an advanced temporal stage of lung disease. The majority PE-positive patients were hospitalized in non-intensive wards. PE-positive patients showed a slightly higher hospitalization time in comparison with PE-negative ones. In the three months of study, overall 85.9% of patients were discharged while 14.1% died, of whom 13 PE-positive (54.2%).ConclusionsPatients hospitalized for SARS-CoV-2 infection present a higher cumulative incidence of PE compared to the general population of hospitalized patients, regardless of the severity of lung inflammation or the temporal stage of the disease.

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