2026-06-14T03:02:08Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/238412024-11-29T01:21:23Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967
Repisalud
author
Suarez Castillejo, Carla
author
Calvo, Néstor
author
Preda, Luminita
author
Toledo Pons, Nuria
author
Millán-Pons, Aina Rosa
author
Martinez, Joaquin
author
Ramon, Luisa
author
Iglesias, Amanda
author
Morell Garcia, Daniel
author
Bauça, Josep Miquel
author
Núñez, Belén
author
Sauleda, Jaume
author
Sala Llinàs, Ernest
author
Alonso-Fernandez, Alberto
2024-10-09T07:09:22Z
2024-10-09T07:09:22Z
2024-02-09
Suárez-Castillejo C, Calvo N, Preda L, Toledo-Pons N, Millón-Pons AR, Martínez J, et al. Pulmonary thrombosis associated with COVID-19 pneumonia: Beyond classical pulmonary thromboembolism. Eur J Clin Invest. 2024 Feb 9;e14176.
10.1111/eci.1417610.1111/eci.14176
1365-2362
European journal of clinical investigation
https://hdl.handle.net/20.500.13003/20204
38339827
L2028501417
2-s2.0-85184914315
https://hdl.handle.net/20.500.12105/23841
1160819600001
Background: Classical pulmonary thromboembolism (TE) and local pulmonary thrombosis (PT) have been suggested as mechanisms of thrombosis in COVID-19. However, robust evidence is still lacking because this was mainly based on retrospective studies, in which patients were included when TE was suspected. Methods: All patients with COVID-19 pneumonia underwent computed tomography and pulmonary angiography in a prospective study. The main objective was to determine the number and percentage of thrombi surrounded by lung opacification (TSO) in each patient, as well as their relationship with percentage of lung involvement (TLI), to distinguish classical TE (with a random location of thrombi that should correspond to a percentage of TSO equivalent to the TLI) from PT. We determined TLI by artificial intelligence. Analyses at patient level (TLI and percentage of TSO) and at thrombi level (TLI and TSO) were performed. Results: We diagnosed TE in 70 out of 184 patients. Three (2-8) thrombi/patient were detected. The percentage of TSO was 100% (75-100) per patient, and TLI was 19.9% (4.6-35.2). Sixty-five patients (92.9%) were above the random scenario with higher percentage of TSO than TLI. Most thrombi were TSO (n = 299, 75.1%). When evaluating by TLI (<10%, 10%-20%, 20%-30% and >30%), percentage of TSO was higher in most groups. Thrombi were mainly in subsegmental/segmental arteries, and percentage of TSO was higher in all locations. Conclusions: Thrombi in COVID-19 were found within lung opacities in a higher percentage than lung involvement, regardless of TLI and clot location, supporting the hypothesis of local PT rather than "classic TE".
eng
Pulmonary thrombosis associated with COVID-19 pneumonia: Beyond classical pulmonary thromboembolism
research article