White blood count, D‐dimers, and ferritin levels as predictive factors of pulmonary embolism suspected upon admission in noncritically ill COVID‐19 patients: The French multicenter CLOTVID retrospective study
J. Galland, Benjamin Thoreau, Maxime Delrue, Marie Neuwirth, Alain Stepanian, Anthony Chauvin, Azeddine Dellal, O. Nallet, Mélanie Roriz, Mathilde Devaux, Jonathan London, Gonzague Martin‐Lecamp, Antoine Froissart, Nouara Arab, B Ferron, Marie‐Helene Groff, V. Queyrel, Christine Lorut, Lucile Regard, E. Berthoux, Guillaume Bayer, C. Comarmond, Bertrand Lioger, A. Mékinian, Tali‐Anne Szwebel, Thomas Sené, Blanca Amador‐Boreiro, O. Mangin, Pierre‐Olivier Sellier, Stéphane Mouly, Jean-Philippe Kévorkian, Virginie Siguret, Lariboisière COVID Group, Dominique Vodovar, D. Sène
Abstract
BACKGROUND: A high prevalence of pulmonary embolism (PE) has been described during COVID-19. Our aim was to identify predictive factors of PE in non-ICU hospitalized COVID-19 patients. METHODS: Data and outcomes were collected upon admission during a French multicenter retrospective study, including patients hospitalized for COVID-19, with a CT pulmonary angiography (CTPA) performed in the emergency department for suspected PE. Predictive factors significantly associated with PE were identified through a multivariate regression model. RESULTS: A total of 88 patients (median [IQR] age of 68 years [60-78]) were analyzed. Based on CTPA, 47 (53.4%) patients were diagnosed with PE, and 41 were not. D-dimer ≥3000 ng/mL (OR 8.2 [95% CI] 1.3-74.2, sensitivity (Se) 0.84, specificity (Sp) 0.78, P = .03), white blood count (WBC) ≥12.0 G/L (29.5 [2.3-1221.2], Se 0.47, Sp 0.92, P = .02), and ferritin ≥480 µg/L (17.0 [1.7-553.3], Se 0.96, Sp 0.44, P = .03) were independently associated with the PE diagnosis. The presence of the double criterion D-dimer ≥3000 ng/mL and WBC ≥12.0 G/L was greatly associated with PE (OR 21.4 [4.0-397.9], P = .004). CONCLUSION: The white blood count, the D-dimer and ferritin levels could be used as an indication for CTPA to confirm PE on admission in non-ICU COVID-19 patients.