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unidades de cuidados intensivos &#40;UCI&#41;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">2&#44;4&#44;6</span></a> y en pacientes hospitalizados en plantas<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">5&#8211;7</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Hasta donde sabemos&#44; no se ha investigado el cambio en la incidencia de TEP en la poblaci&#243;n general durante la pandemia&#44; ni las posibles caracter&#237;sticas diferenciales de los TEP sucedidos durante ese per&#237;odo&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Poblaci&#243;n y m&#233;todo</span><p id="par0015" class="elsevierStylePara elsevierViewall">Hemos realizado un estudio retrospectivo utilizando el archivo radiol&#243;gico y las historias cl&#237;nicas electr&#243;nicas de un hospital universitario de la Comunidad de Madrid &#40;Espa&#241;a&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Se definieron dos intervalos de tiempo&#58; el per&#237;odo de estudio&#44; desde el 01 de marzo al 31 de mayo de 2020&#59; y un per&#237;odo de control&#44; que comprende el mismo intervalo en 2019&#46; Durante esos per&#237;odos se identificaron todas las solicitudes de angiograf&#237;a pulmonar por tomograf&#237;a computarizada &#40;APTC&#41;&#44; en las que constaba la sospecha cl&#237;nica de TEP&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Los estudios hab&#237;an sido realizados con tomograf&#237;a computarizada &#40;TC&#41; multidetector &#40;Brilliance&#59; Philips&#44; Eindhoven&#44; Pa&#237;ses Bajos&#41; mediante protocolos est&#225;ndar&#46; Todos ellos fueron reanalizados por dos radi&#243;logos expertos con el fin de detectar la presencia de defectos de relleno intraluminal en las arterias pulmonares proximales o distales &#40;segmentarias o subsegmentarias&#41;&#46; Se recuper&#243; la historia cl&#237;nica de los pacientes finalmente diagnosticados de TEP&#44; y se registraron las condiciones cl&#237;nicas predisponentes al TEP recogidas en la escala revisada de Ginebra<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a>&#44; as&#237; como como el d&#237;mero D&#44; determinado por inmunoturbidimetr&#237;a &#40;STA&#174;-Liatest&#174; D-Di Plus&#44; Stago&#44; Asni&#232;res-sur-Seine&#44; Francia&#41;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Durante el per&#237;odo de estudio&#44; se registraron los resultados de la reacci&#243;n en cadena de la polimerasa a tiempo real &#40;RT-PCR&#41; para el SARS-CoV-2 y el tiempo desde el inicio de los s&#237;ntomas de COVID-19 y la sospecha de TEP&#46; El diagn&#243;stico de COVID-19 se bas&#243; en los criterios de la Organizaci&#243;n Mundial de la Salud &#40;OMS&#41;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">La incidencia de COVID-19 en la poblaci&#243;n atendida por el hospital se obtuvo consultando registros p&#250;blicos<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">11</span></a>&#46; Se utiliz&#243; la prueba de &#967;<span class="elsevierStyleSup">2</span> para las variables cualitativas &#40;expresadas como proporciones&#41;&#44; y la comparaci&#243;n de medias de Spearman &#40;para variables no relacionadas&#41; para las cuantitativas&#44; expresadas como media &#177; desviaci&#243;n est&#225;ndar&#46; Se consider&#243; significativa una p &#60; 0&#44;05&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">La raz&#243;n de riesgo de TEP entre ambos per&#237;odos se calcul&#243; utilizando el n&#250;mero de TEP detectados y la poblaci&#243;n atendida en cada per&#237;odo&#44; con un intervalo de confianza &#40;IC&#41; del 95&#37;&#46; Los datos se analizaron con el programa IBM SPSS 22 &#40;Armonk&#44; NY&#44; EE&#46; UU&#46;&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">El estudio fue aprobado por el Comit&#233; de &#201;tica de la investigaci&#243;n del hospital &#40;OE33&#47;2020&#41;&#44; que eximi&#243; de la necesidad de obtener consentimiento&#44; dada la naturaleza retrospectiva del estudio&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se solicit&#243; una APTC por sospecha de TEP durante el per&#237;odo de control a 145 pacientes&#44; 22 de ellos &#40;15&#44;2&#37;&#41; finalmente diagnosticados de TEP&#46; Durante el per&#237;odo de estudio se solicitaron 465 APTC por sospecha de TEP&#44; 99 de ellos &#40;21&#44;3&#37;&#41; confirmados&#44; ocho &#40;8&#37;&#41; ingresados en UCI&#46; Un total de 74 hab&#237;an sido previamente diagnosticados de COVID-19&#44; con un retraso medio entre ambos diagn&#243;sticos de 9&#44;1 &#177; 8&#44;4 d&#237;as&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">De los 1&#46;292 pacientes hospitalizados con diagn&#243;stico de COVID-19 en ese per&#237;odo&#44; el 5&#44;7&#37; &#40;74&#41; fueron diagnosticados de TEP&#46; Considerando la poblaci&#243;n atendida por el hospital&#44; el riesgo de TEP durante el per&#237;odo de estudio&#44; en relaci&#243;n con el per&#237;odo de control&#44; fue de 4&#44;5 &#40;IC 95&#37; 2&#44;80-6&#44;99&#41;&#46; La <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> muestra que las curvas de incidencia de TEP y de COVID-19&#44; estimadas para la poblaci&#243;n atendida por el hospital&#44; tuvieron una tendencia similar&#44; pero la de TEP suced&#237;a con retraso&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> resume el resto de los resultados&#46; Durante el per&#237;odo de estudio&#44; los pacientes con TEP tendieron a ser m&#225;s frecuentemente hombres &#40;69&#44;7 vs&#46; 54&#44;5&#37;&#44; p &#61; NS&#41;&#44; sin diferencias relevantes de la edad media &#40;65&#44;1<span class="elsevierStyleMonospace">&#177;</span>19&#44;0 vs&#46; 66&#44;6<span class="elsevierStyleMonospace">&#177;</span>15&#44;0&#44; p &#61; NS&#41;&#46; Tuvieron menos episodios de TEP previo &#40;5&#44;1 vs&#46; 18&#44;2&#37;&#44; p &#61; 0&#44;05&#41;&#44; de trombosis venosa profunda &#40;TVP&#41; &#40;11&#44;1 vs&#46; 45&#44;5&#37;&#44; p &#61; 0&#44;0001&#41; y de cirug&#237;a en el mes anterior &#40;2 vs&#46; 35&#44;4&#37;&#44; p &#61; 0&#44;0001&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Los niveles de d&#237;mero D fueron m&#225;s altos en los TEP asociados con COVID-19 &#40;11&#44;9<span class="elsevierStyleMonospace">&#177;</span>27&#44;5 vs&#46; 3&#44;4<span class="elsevierStyleMonospace">&#177;</span>5&#44;0 mg&#47;L&#44; p &#61; 0&#44;017&#41;&#44; y tendieron a ser m&#225;s altos&#44; pero no significativamente&#44; durante el per&#237;odo de estudio&#46; Los TEP fueron m&#225;s frecuentemente distales durante el per&#237;odo pand&#233;mico &#40;73&#44;5 vs&#46; 50&#37;&#44; p &#61; 0&#44;02&#41;&#44; y tambi&#233;n en los pacientes con COVID-19 frente a los que no ten&#237;an COVID-19 &#40;83&#44;6 vs&#46; 57&#44;9&#37;&#44; p &#61; 0&#44;005&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">Nuestro estudio muestra un incremento en la incidencia de TEP durante los primeros meses de la pandemia&#44; con un riesgo hasta 4&#44;5 veces superior al del mismo per&#237;odo del a&#241;o anterior&#46; Incluye TEP asociados y no asociados a COVID-19&#59; en las plantas de hospitalizaci&#243;n &#40;91 casos&#41; y en las UCI &#40;ocho casos&#41;&#46; La diferencia entre ambos per&#237;odos &#40;77 casos&#41; coincide pr&#225;cticamente con los casos de TEP asociado con COVID-19 &#40;74 episodios&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Algunos autores<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a> han descrito una incidencia acumulativa de TEP del 24&#37; en pacientes con COVID-19 en los que se realiz&#243; una APTC&#46; Este dato lleva a confusi&#243;n&#44; porque se refiere a la proporci&#243;n de estudios positivos en los pacientes a los que por alguna raz&#243;n se hizo la prueba&#44; y no a la prevalencia en toda la poblaci&#243;n ingresada con COVID-19&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Algunos metaan&#225;lisis han mostrado una alta incidencia de TEP&#44; pero la mayor&#237;a de los casos incluidos proven&#237;an de pacientes ingresados en UCI&#44; en los que la incidencia es mayor<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a>&#46; Siendo as&#237;&#44; la informaci&#243;n m&#225;s clara la podemos encontrar en series concretas&#46; En una serie de 184 pacientes con COVID-19 admitidos en tres UCI&#44; 25 &#40;13&#44;6&#37;&#41; sufrieron un TEP<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">1</span></a>&#44; dato similar &#40;16&#44;7&#37;&#41; al que ofreci&#243; un an&#225;lisis prospectivo de 150 pacientes consecutivos admitidos en otras cuatro UCI<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En el otro extremo&#44; una serie de pacientes admitidos en las plantas de Medicina Interna de un hospital mostr&#243; una incidencia de TEP de 6&#44;2&#37;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a>&#44; similar a nuestro hallazgo de 5&#44;7&#37;&#46; As&#237; pues&#44; alrededor de un 6&#37; de los pacientes ingresados por COVID-19 puede sufrir un TEP&#44; subiendo hasta el 13-17&#37; en los casos cr&#237;ticos en la UCI&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Hemos observado un retraso entre el diagn&#243;stico de COVID-19 y la sospecha de TEP&#44; claramente apreciable en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; Todo ello nos debe poner alerta ante datos de deterioro de los pacientes con COVID-19&#44; a partir de la primera semana de su ingreso&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Los TEP encontrados durante el per&#237;odo de pandemia difer&#237;an de los diagnosticados el a&#241;o previo&#44; con menos condiciones predisponentes para sufrirlo y m&#225;s a menudo con obstrucci&#243;n distal&#46; Lo mismo ocurri&#243; cuando comparamos a los pacientes con TEP&#44; con y sin COVID-19&#46; La COVID-19 parece estar asociada por s&#237; misma con un mayor riesgo de desarrollar TEP&#44; probablemente mayor que el descrito para otros tipos de neumon&#237;a&#44; en los que tambi&#233;n el TEP distal es m&#225;s com&#250;n<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Otros autores tambi&#233;n han encontrado un aumento del TEP distal en los pacientes con COVID-19<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a>&#44; y esto podr&#237;a deberse al menos en parte a la asociaci&#243;n de COVID-19 con la trombosis pulmonar <span class="elsevierStyleItalic">in situ</span><a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a>&#46; En parte&#44; porque cabe esperar un aumento de otros tipos de TEP durante la pandemia&#44; ya que el confinamiento puede ser causa de inmovilizaci&#243;n y ha habido un aumento dram&#225;tico en el n&#250;mero de pacientes cr&#237;ticamente enfermos con mayor riesgo de TEP&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Limitaciones</span><p id="par0105" class="elsevierStylePara elsevierViewall">La naturaleza retrospectiva del estudio no permite la estandarizaci&#243;n de la sospecha de TEP&#46; No se ha realizado una estratificaci&#243;n de riesgo de los TEP observados por el escaso tama&#241;o de la muestra&#46; La TVP puede no haber sido investigada sistem&#225;ticamente durante el pico de la pandemia debido a razones log&#237;sticas&#46; La mayor&#237;a de las muestras para RT-PCR se obtuvieron usando hisopos nasofar&#237;ngeos&#44; una t&#233;cnica con una sensibilidad estimada del 63&#37;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a>&#44; por lo que algunos de los 25 casos de TEP sin diagn&#243;stico de COVID-19 podr&#237;an haber estado infectados&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La incidencia de TEP estimada para la poblaci&#243;n es solo una aproximaci&#243;n&#58; ha habido muchas causas posibles de p&#233;rdida de casos que podr&#237;an causar subestimaci&#243;n&#44; incluyendo los pacientes que murieron en residencias y los casos terminales no investigados&#46; En todo caso&#44; la incidencia real de TEP durante la pandemia deber&#237;a ser mayor&#44; y no menor que durante el per&#237;odo de control&#44; y reforzar&#237;a la hip&#243;tesis inicial&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Tambi&#233;n podr&#237;a pensarse que la TC haya sido infrautilizada debido a situaci&#243;n de emergencia&#46; Sin embargo&#44; se orden&#243; una APTC por la sospecha de TEP en un tercio de los pacientes ingresados por COVID-19 durante el per&#237;odo de estudio&#44; con una tasa de diagn&#243;stico confirmado del 21&#44;3&#37;&#44; que no fue no estad&#237;sticamente diferente de la tasa encontrada durante el per&#237;odo de control&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Cuando se utiliza correctamente&#44; la APTC debe detectar un TEP en el 30&#37; de todas las APTC solicitadas<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">17</span></a>&#44; por lo que nuestros datos no sugieren infrautilizaci&#243;n en ninguno de los per&#237;odos&#44; y concuerdan con la capacidad diagn&#243;stica de la prueba en otros estudios realizados en pacientes con COVID-19<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusiones</span><p id="par0125" class="elsevierStylePara elsevierViewall">La pandemia de COVID-19 se asocia con un mayor riesgo de TEP&#46; Este riesgo parece aumentar una o dos semanas despu&#233;s de la infecci&#243;n&#46; Durante el per&#237;odo pand&#233;mico&#44; el TEP afecta a pacientes con un perfil cl&#237;nico diferente&#44; frecuentemente con COVID-19&#44; y la obstrucci&#243;n de los vasos es m&#225;s frecuentemente distal&#46; Nuestros resultados respaldan la hip&#243;tesis de que la COVID-19 es un factor de riesgo para sufrir un TEP&#44; con caracter&#237;sticas espec&#237;ficas&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Financiaci&#243;n</span><p id="par0135" class="elsevierStylePara elsevierViewall">La presente investigaci&#243;n no ha recibido ayudas espec&#237;ficas provenientes de agencias del sector p&#250;blico&#44; sector comercial o entidades sin &#225;nimo de lucro&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se ha descrito una elevada incidencia de tromboembolismo pulmonar &#40;TEP&#41; durante la pandemia por coronavirus&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo unic&#233;ntrico&#44; con revisi&#243;n de las angiograf&#237;as pulmonares por tomograf&#237;a computarizada solicitadas por sospecha de tromboembolismo pulmonar durante dos per&#237;odos&#44; del 01 de marzo del 2020 al 31de mayo del 2020 &#40;pandemia&#41;&#44; e igual intervalo en 2019 &#40;control&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se diagnosticaron 22 tromboembolismos pulmonares durante el per&#237;odo control y 99 en el pand&#233;mico&#44; 74 asociados con COVID-19&#46; El 5&#44;3&#37; de los pacientes hospitalizados con COVID-19 sufri&#243; un tromboembolismo pulmonar&#44; con un retraso entre ambos diagn&#243;sticos de 9&#44;1 &#177; 8&#44;4 d&#237;as&#46; Durante la pandemia&#44; los pacientes con tromboembolismo pulmonar ten&#237;an menos condiciones predisponentes &#40;tromboembolismo pulmonar previo 5&#44;1 vs&#46; 18&#44;2&#37;&#44; p &#61; 0&#44;05&#44; cirug&#237;a previa 2 vs&#46; 35&#44;4&#37;&#44; p &#61; 0&#44;0001&#44; trombosis venosa profunda 11&#44;1 vs&#46; 45&#44;5&#37;&#44; p &#61; 0&#44;0001&#41;&#44; y los tromboembolismos pulmonares perif&#233;ricos eran m&#225;s frecuentes &#40;73&#44;5 vs&#46; 50&#37;&#44; p &#61; 0&#44;029&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Existe un riesgo incrementado de sufrir un TEP durante la pandemia por SARS-CoV-2&#44; que afecta a pacientes con perfil cl&#237;nico diferente y causa m&#225;s frecuentemente TEP distales&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A high incidence of pulmonary embolism has been described during the coronavirus pandemic&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This work is a single-center retrospective study which reviewed computed tomography pulmonary angiograms ordered due to suspected pulmonary embolism during two periods&#58; from March 1&#44; 2020 to May 31&#44; 2020 &#40;pandemic&#41; and during the same interval in 2019 &#40;control&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Twenty-two pulmonary embolism were diagnosed during the control period and 99 in the pandemic&#44; 74 of which were associated with COVID-19&#46; Of all patients hospitalized with COVID-19&#44; 5&#46;3&#37; had a pulmonary embolism&#44; with a delay between the two diagnoses of 9&#46;1 &#177; 8&#46;4 days&#46; During the pandemic&#44; patients with pulmonary embolism had fewer predisposing conditions &#40;previous pulmonary embolism 5&#46;1 vs&#46; 18&#46;2&#37;&#44; p &#61; &#46;05&#59; previous surgery 2 vs&#46; 35&#46;4&#37;&#44; p &#61; &#46;0001&#59; deep vein thrombosis 11&#46;1 vs&#46; 45&#46;5&#37;&#44; p &#61; &#46;0001&#41;&#59; peripheral pulmonary embolisms were the most frequent &#40;73&#46;5 vs&#46; 50&#37;&#44; p &#61; &#46; 029&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">There is an increased risk of having a pulmonary embolism during the SARS-CoV-2 pandemic&#44; which affects patients with a different clinical profile and more often causes distal pulmonary embolisms&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;fica de incidencias de COVID-19 y TEP en la poblaci&#243;n de referencia durante la pandemia&#46; Las l&#237;neas representan la suma diaria de casos durante los 14 d&#237;as anteriores&#44; tanto para COVID-19 como para los casos de TEP en la poblaci&#243;n de referencia del hospital&#46; La escala de incidencia de TEP es diez veces menor que la de COVID-19&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">TEP&#58; tromboembolismo pulmonar&#46;</p>"
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        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
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            "rol" => "short"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">IC&#58; intervalo de confianza&#59; LDH&#58; deshidrogenasa l&#225;ctica&#59; lpm&#58; latidos por minuto&#59; Muerte&#58; muerte intrahospitalaria&#59; PCR&#58; prote&#237;na C reactiva&#59; RR&#58; raz&#243;n de riesgo&#59; RT-PCR&#58; reacci&#243;n en cadena de la polimerasa con transcriptasa inversa&#59; Sat O<span class="elsevierStyleInf">2</span>&#58; saturaci&#243;n de ox&#237;geno&#59; TVP&#58; trombosis venosa profunda&#59; UCI&#58; ingreso en Unidad de Cuidados Intensivos&#59; NS&#58; no significativo&#46;</p>"
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            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Per&#237;odo</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Significaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Casos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RR 4&#44;5 &#40;IC 95&#37; 2&#44;80-6&#44;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">G&#233;nero &#40;var&#243;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;54&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;69&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad media &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#44;1<span class="elsevierStyleMonospace">&#177;</span>19&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#44;6<span class="elsevierStyleMonospace">&#177;</span>15&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">COVID-19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;73&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TEP previo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;18&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirug&#237;a en el mes previo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;35&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neoplasia activa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;12&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TVP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;45&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;11&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TEP perif&#233;rico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;73&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;029&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frecuencia cardiaca &#40;lpm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98<span class="elsevierStyleMonospace">&#177;</span>27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90<span class="elsevierStyleMonospace">&#177;</span>23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sat O<span class="elsevierStyleInf">2</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91<span class="elsevierStyleMonospace">&#177;</span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89<span class="elsevierStyleMonospace">&#177;</span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neutr&#243;filos &#40;x10<span class="elsevierStyleSup">3</span>&#47;&#956;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;252<span class="elsevierStyleMonospace">&#177;</span>3&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;666<span class="elsevierStyleMonospace">&#177;</span>4&#46;744&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">PCR mg&#47;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53&#44;8<span class="elsevierStyleMonospace">&#177;</span>69&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Ferritina &#951;gr&#47;mL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">691<span class="elsevierStyleMonospace">&#177;</span>629&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">UCI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;9&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;8&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Muerte&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;9&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Datos cl&#237;nicos y radiol&#243;gicos de pacientes con diagn&#243;stico de tromboembolismo pulmonar &#40;TEP&#41; durante el per&#237;odo de control &#40;2019&#41; y el per&#237;odo pand&#233;mico &#40;2020&#41;</p>"
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                          "etal" => true
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                            3 => "I&#46; Ntanasis-Stathopoulos"
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                            5 => "E&#46; Kastritis"
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                            3 => "M&#46;S&#46; Arbous"
                            4 => "D&#46; Gommers"
                            5 => "K&#46;M&#46; Kant"
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                            4 => "H&#46; Abdoul"
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                      "titulo" => "Incidence of pulmonary embolism in non-critically ill COVID-19 patients&#46; Predicting factors for a challenging diagnosis"
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                            3 => "A&#46; Franco-Moreno"
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                            5 => "D&#46; Salazar-Chiriboga"
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                    0 => array:2 [
                      "doi" => "10.1007/s11239-020-02190-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thromb Thrombolysis&#46;"
                        "fecha" => "2020"
                        "volumen" => "29"
                        "paginaInicial" => "1"
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                      "titulo" => "Prediction of pulmonary embolism in the emergency department&#58; the revised Geneva score"
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Vol. 222. Issue 6.
Pages 354-358 (June - July 2022)
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Vol. 222. Issue 6.
Pages 354-358 (June - July 2022)
ORIGINAL BREVE
Tromboembolismo pulmonar durante la pandemia por SARS-CoV-2: características clínicas y radiológicas
Pulmonary embolism during SARS-CoV-2 pandemic: clinical and radiological features
A. García-Lledóa,b,
Corresponding author
josealberto.garcia@salud.madrid.org

Autor para correspondencia.
, M. del Palacio-Salgadoc, C. Álvarez-Sanzb,c, M.M. Pérez-Gila, Á. Cruz-Díazb,c
a Servicio de Cardiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
b Departamento de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España
c Servicio de Radiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
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Tabla 1. Datos clínicos y radiológicos de pacientes con diagnóstico de tromboembolismo pulmonar (TEP) durante el período de control (2019) y el período pandémico (2020)
Resumen
Antecedentes

Se ha descrito una elevada incidencia de tromboembolismo pulmonar (TEP) durante la pandemia por coronavirus.

Métodos

Estudio retrospectivo unicéntrico, con revisión de las angiografías pulmonares por tomografía computarizada solicitadas por sospecha de tromboembolismo pulmonar durante dos períodos, del 01 de marzo del 2020 al 31de mayo del 2020 (pandemia), e igual intervalo en 2019 (control).

Resultados

Se diagnosticaron 22 tromboembolismos pulmonares durante el período control y 99 en el pandémico, 74 asociados con COVID-19. El 5,3% de los pacientes hospitalizados con COVID-19 sufrió un tromboembolismo pulmonar, con un retraso entre ambos diagnósticos de 9,1 ± 8,4 días. Durante la pandemia, los pacientes con tromboembolismo pulmonar tenían menos condiciones predisponentes (tromboembolismo pulmonar previo 5,1 vs. 18,2%, p = 0,05, cirugía previa 2 vs. 35,4%, p = 0,0001, trombosis venosa profunda 11,1 vs. 45,5%, p = 0,0001), y los tromboembolismos pulmonares periféricos eran más frecuentes (73,5 vs. 50%, p = 0,029).

Conclusiones

Existe un riesgo incrementado de sufrir un TEP durante la pandemia por SARS-CoV-2, que afecta a pacientes con perfil clínico diferente y causa más frecuentemente TEP distales.

Palabras clave:
COVID-19
Embolismo pulmonar
SARS-CoV-2
Coronavirus
Trombosis
Abstract
Background

A high incidence of pulmonary embolism has been described during the coronavirus pandemic.

Methods

This work is a single-center retrospective study which reviewed computed tomography pulmonary angiograms ordered due to suspected pulmonary embolism during two periods: from March 1, 2020 to May 31, 2020 (pandemic) and during the same interval in 2019 (control).

Results

Twenty-two pulmonary embolism were diagnosed during the control period and 99 in the pandemic, 74 of which were associated with COVID-19. Of all patients hospitalized with COVID-19, 5.3% had a pulmonary embolism, with a delay between the two diagnoses of 9.1 ± 8.4 days. During the pandemic, patients with pulmonary embolism had fewer predisposing conditions (previous pulmonary embolism 5.1 vs. 18.2%, p = .05; previous surgery 2 vs. 35.4%, p = .0001; deep vein thrombosis 11.1 vs. 45.5%, p = .0001); peripheral pulmonary embolisms were the most frequent (73.5 vs. 50%, p = . 029).

Conclusions

There is an increased risk of having a pulmonary embolism during the SARS-CoV-2 pandemic, which affects patients with a different clinical profile and more often causes distal pulmonary embolisms.

Keywords:
COVID-19
Pulmonary embolism
SARS-CoV-2
Coronavirus
Thrombosis

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