A retrospective case series was conducted on 19 COVID-19 patients with suspected PE for CTPA on the basis of clinical signs and elevated d-dimers in the Central Hospital of Wuhan from January 10 to March 26, 2020. COVID-19 was diagnosed in accordance with the interim guidance of the WHO . Only patients with laboratory-confirmed SARS-CoV-2 infection from throat swab specimens were enrolled. All patients were followed up until discharge or death. The requirement for informed consent was waived due to the urgency to collect data on the emerging SARS-CoV-2. This study was approved by the Ethics Committees of the Central Hospital of Wuhan.
The clinical electronic medical records of 19 patients with SARS-CoV-2 infection
were reviewed by three first-line clinical physicians (Y.G, W.S, and Y.L) and
double-checked by a fourth researcher (Y.Lv.). Demographic, clinical, laboratory,
treatment, and outcome data were extracted using a standardized data collection form modified in accordance with the WHO/International Severe Acute Respiratory and
Emerging Infection Consortium case record forms.
We collected data on clinical records, laboratory findings, chest CT, and CTPA scans. Information on demographic characteristics (gender and age), comorbidities (chronic obstructive pulmonary disease, hypertension, diabetes, cardiovascular disease, cerebrovascular disease, and chronic kidney disease), clinical manifestations, treatment, and outcomes (discharge or death) were extracted from electronic medical records. Laboratory findings, including white blood cell count, neutrophil count, lymphocyte count, hemoglobin, platelet count, C-reactive protein, procalcitonin, blood urea, creatinine, total bilirubin, alanine aminotransferase, aspartate aminotransferase, fibrinogen, d-dimer, lactate dehydrogenase, creatine kinase, and arterial blood gases (lactate and PaO2/FiO2 [the ratio of partial pressure of oxygen to fraction of inspired oxygen]), were collected at admission and the day before or on the day of CTPA completion. Acute Physiology and Chronic Health Evaluation II scores (APACHE II), sequential organ failure assessment (SOFA), CURB-65 criteria and Simplified were determined within 24 h after admission. Wells’ scores  were determined at the day before or on the day of CTPA completion. Data on all treatment measures, including antibiotic, antivirus, glucocorticoid, and intravenous immunoglobulin therapy, anticoagulation therapy, and respiratory support, were acquired during hospitalization. Throat swab samples were collected from all suspected patients, and the laboratory confirmation of SARS-CoV-2 was performed using real-time reverse transcription polymerase chain reaction in accordance with the manufacturer’s protocol (Shanghai ZJ Bio-Tech Co., Ltd. Or Xi’an Tianlong Science and Technology Co., Ltd).
PE is a form of venous thromboembolism (VTE) in which an embolus (a travelling blood clot) blocks the blood vessels of the pulmonary artery tree, which can ultimately result in sudden death . Acute respiratory distress syndrome (ARDS) was determined by the consensus of two trained physician reviewers using the Berlin definition, that is, the development of acute, bilateral pulmonary infiltrates, and hypoxemia (PaO2/FiO2 ≤ 300 mm Hg) not primarily due to heart failure or volume overload .
We summarized continuous variables as medians with interquartile rages (IQR) and categorical variables with n (%). Since our study is a case series study, statistical comparison is not necessary. All analyses were performed by using SPSS, version 20.0.