Pulmonary embolism is common among obese COVID-19 patients

Patients with COVID-19 infection with a BMI of 30 or higher are nearly three times more at risk for developing a pulmonary embolism

In a new study published in the journal Radiology, researchers found that every fifth COVID-19 patient who underwent a pulmonary CT angiography was diagnosed with pulmonary embolism (PE). They also found that obesity was a major risk factor for development of PE.

Pulmonary embolism occurs when a blood clot (thrombus) in a deep vein, usually in the legs, is dislodged and travels to the lungs where it blocks one or more vessels. This typically occurs if the vein wall is damaged, blood flow is too slow, or the blood becomes too thick. Symptoms including shortness of breath and chest pain resemble other diseases so the diagnosis is often missed, or the severity of the situation is underestimated, and many patients usually die before getting appropriate therapy.

In Europe, studies have shown that most cases of PE were diagnosed in patients admitted to the intensive care unit after being on a ventilator for several days.

The study included 328 COVID-19 patients who underwent a pulmonary CT angiography between March 16 and April 18 at Henry Ford’s acute care hospitals. 72 percent of PE diagnoses were made in patients who did not require ICU-level care, suggesting that timely diagnosis and use of blood thinners could have played a role in the treatment process.

Increased D-dimer and C-reactive protein lab markers, in conjunction with a rising oxygen requirement, may be a predictor of a pulmonary embolism, even when patients are receiving preventive blood thinners

“Based on our study, early detection of PE could further enhance and optimize treatment for patients first presenting in the Emergency Department,” said Pallavi Bhargava, M.D., an infectious diseases physician and co-author of the study. “We advise clinicians to think of PE as an additional complication early on during the admission of patients whose symptoms and lab results point to that condition.”

Key highlight of the study : 

1. 22 percent of patients were found to have a pulmonary embolism.
2. Patients with a BMI (body mass index) of 30 or higher are nearly three times more at risk for developing a pulmonary embolism. The ideal BMI for adults is 18.5 – 24.9.
3. Patients on statin therapy prior to admission were less likely to develop a pulmonary embolism.
4. Increased D-dimer and C-reactive protein lab markers, in conjunction with a rising oxygen requirement, may be a predictor of a pulmonary embolism, even when patients are receiving preventive blood thinners.

Researchers said early diagnosis of a life-threatening blood clot in the lungs could lead to faster treatment intervention in COVID-19 patients which in turn could reduce need for ICU care.