scholarly journals Effectiveness of mid-regional pro-adrenomedullin (MR-proADM) as prognostic marker in COVID-19 critically ill patients: An observational prospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246771
Author(s):  
Giorgia Montrucchio ◽  
Gabriele Sales ◽  
Francesca Rumbolo ◽  
Filippo Palmesino ◽  
Vito Fanelli ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
University Hospital ◽  
Rank Test ◽  
Operating Characteristics ◽  
Icu Patients ◽  
Dying Patients ◽  
D Dimer ◽  
Over Time

Objective To test the effectiveness of mid-regional pro-adrenomedullin (MR-proADM) in comparison to C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH) in predicting mortality in COVID-19-ICU-patients. Methods All consecutive COVID-19 adult patients admitted between March and June 2020 to the ICU of a referral, university hospital in Northern-Italy were enrolled. MR-proADM and routine laboratory test were measured within 48 hours from ICU admission, on day 3, 7 and 14. Survival curves difference with MR-proADM cut-off set to 1.8 nmol/L were tested using log-rank test. Predictive ability was compared using area under the curve and 95% confidence interval of different receiver-operating characteristics curves. Results 57 patients were enrolled. ICU and overall mortality were 54.4%. At admission, lymphocytopenia was present in 86% of patients; increased D-dimer and CRP levels were found in 84.2% and 87.7% of patients respectively, while PCT values > 0.5 μg/L were observed in 47.4% of patients. MR-proADM, CRP and LDH were significantly different between surviving and non-surviving patients and over time, while PCT, D-dimer and NT-pro-BNP did not show any difference between the groups and over time; lymphocytes were different between surviving and non-surviving patients only. MR-proADM was higher in dying patients (2.65±2.33vs1.18±0.47, p<0.001) and a higher mortality characterized patients with MR-proADM >1.8 nmol/L (p = 0.016). The logistic regression model adjusted for age, gender, cardiovascular disease, diabetes mellitus and PCT values confirmed an odds ratio = 10.3 [95%CI:1.9–53.6] (p = 0.006) for MR-proADM >1.8 nmol/L and = 22.2 [95%CI:1.6–316.9] (p = 0.022) for cardiovascular disease. Overall, MR-proADM had the best predictive ability (AUC = 0.85 [95%CI:0.78–0.90]). Conclusions In COVID-19 ICU-patients, MR-proADM seems to have constantly higher values in non-survivor patients and predict mortality more precisely than other biomarkers. Repeated MR-proADM measurement may support a rapid and effective decision-making. Further studies are needed to better explain the mechanisms responsible of the increase in MR-proADM in COVID-19 patients.

scholarly journals Effectiveness of Mid-Regional Pro-Adrenomedullin (MR-proADM) as Prognostic Marker in COVID-19 Critically Ill Patients: an Observational Prospective Study

2020 ◽  
Author(s):  
Giorgia Montrucchio ◽  
Gabriele Sales ◽  
Francesca Rumbolo ◽  
Filippo Palmesino ◽  
Vito Fanelli ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Predictive Ability ◽  
Rank Test ◽  
Operating Characteristics ◽  
Icu Patients ◽  
D Dimer ◽  
Over Time

Abstract Background Due to the lack of validated biomarkers to predict disease progression and mortality in COVID-19 ICU-patients, we tested the effectiveness of mid-regional pro-adrenomedullin (MR-proADM) in comparison to C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH) in predicting outcome.Methods All consecutive COVID-19 adult patients admitted between March and June 2020 to the ICU of the ‘Città della Salute e della Scienza’ hospital in Turin (Italy) were enrolled. MR-proADM, clinical and routine laboratory test were measured within 48 hours from ICU admission, on day 3, 7 and 14. Survival curves difference with MR-proADM cut-off set to 1.8 nmol/L were tested using log-rank test. Predictive ability was compared using area under the curve and 95% confidence interval of different receiver-operating characteristics curves. Potential confounding effects were tested using a logistic regression model. Results Fifty-seven patients were enrolled. ICU and overall mortality were 54.4%. Within the first 24 hours, lymphocytopenia was present in 86%; increased D-dimer and CRP levels were found in 84.2% and 87.7% respectively, while PCT values higher than 0.5 μg/L were observed in 47.4%. MR-proADM, CRP and LDH were significantly different between surviving and non-surviving patients and over time, while PCT, D-dimer and NT-pro-BNP did not show any difference between the groups and over time; lymphocytes count was different between surviving and non-surviving patients only.MR-proADM was higher in dying patients (2.65+2.33vs1.18+0.47, p=0.0001) and a higher mortality characterized patients with MR-proADM exceeding 1.8 nmol/L (p=0.0157). The logistic regression model adjusted for age, gender, cardiovascular disease, diabetes mellitus and PCT values confirmed an odds ratio equal to 10.274 (95%CI 1.970-53.578) (p=0.0057) for MR-proADM higher than 1.8 nmol/L and equal to 22.206 (95%CI 1.56-316.960) (p=0.0223) for cardiovascular disease. Overall, MR-proADM was found to have the best predictive ability (AUC=0.846 – 95%CI 0.779-0.899).Conclusions In COVID-19 ICU-patients, MR-proADM seems able to provide a more precise stratification of disease severity and mortality risk than other biomarkers. Repeated MR-proADM measurement may support a rapid and effective decision-making. Further studies are needed to better explain the mechanisms responsible of the increase in MR-proADM observed in COVID-19 patients.

The Application of Lactate Dehydrogenase in Coronavirus Disease 2019 as the Best Indicator for the Progression and Clinical Status: A Case-Control Study

2020 ◽  
Author(s):  
Yang Li ◽  
Xian Zhou ◽  
Jing-wen Ai ◽  
Hongyu Wang ◽  
Taoping Weng ◽  
...  
Keyword(s):  
T Cell ◽  
Troponin T ◽  
Degradation Products ◽  
Clinical Status ◽  
Area Under The Curve ◽  
Cd4 T Cell ◽  
Operating Characteristics ◽  
Normal Range ◽  
Critical Patients ◽  
D Dimer

Abstract Introduction Coronavirus disease 2019 (COVID-19) is now officially a pandemic. Current studies observed extensive abnormal indexes in COVID-19 patients and significant differences between mild and severe patients. However, which index would perform better as the indicator of disease progression merits further investigation.Methods We enrolled COVID-19 patients who were admitted to Shanghai Public Health Clinical center. We closely monitored the following candidate indictors: white blood cell, lymphocyte, platelet, CD4 T cell, CD8 T cell, alanine aminotransferase, estimated glomerular filtration rate (eGFR), fibrin degradation products (FDP), D-dimer, creatine kinase, myoglobin, troponin T (TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), lactase dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin. The correlation with illness severity were assessed by Spearman analysis and the ability of differentiating the clinical statuses was quantified as the AUC value of the ROC curve. Results A total of 326 patients were enrolled, including 299 mild-ordinary and 27 severe-critical patients. At admission, D-dimer and CRP were elevated above normal range both in mild-ordinary and severe-critical patients. LDH, NT-proBNP, myoglobin, CD4 T cell, eGFR, FDP and PCT were beyond normal range in the mild-ordinary stages of severe-critical patients, but remained normal in the persistently mild-ordinary patients. Top 5 parameters with highest spearmen coefficient were LDH, procalcitonin, NT-proBNP, myoglobin and D-dimer (Spearman coefficient: 0.488, 0.453, 0.414, 0.412, 0.407). Comparing between mild-ordinary stage and severe/critical stage, LDH showed the highest receiver operating characteristics (ROC) area under the curve (AUC) of 0.951. PCT ranked second, with the ROC AUC of 0.905. Comparing between mild-ordinary and severe stages, only LDH had the ROC AUC of over 0.90 (0.927). Conclusions This study found LDH to be a superior indicator for COVID-19 status and had the potential to optimize the clinical management strategy.

scholarly journals Effect of dual tocolysis with fenoterol and atosiban in human myometrium

2019 ◽  
Vol 47 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Bernhard Stoiber ◽  
Christian Haslinger ◽  
Marie Kristin Schäffer ◽  
Roland Zimmermann ◽  
Leonhard Schäffer
Keyword(s):  
Area Under The Curve ◽  
Antagonistic Effect ◽  
Additive Effect ◽  
University Hospital ◽  
Rank Test ◽  
Human Myometrium ◽  
Tissue Samples ◽  
Significant Difference ◽  
Signed Rank Test

Abstract Objectives To measure the tocolytic effect of the combination of the oxytocin receptor antagonist atosiban with the β-mimetic agent fenoterol on human myometrium of pregnant women. Methods An in vitro study of contractility in human myometrium at the Laboratory of the Department of Obstetrics, University Hospital of Zürich, Switzerland, was performed. Thirty-six human myometrial biopsies were obtained during elective caesarean sections of singleton pregnancies at term. Tissue samples were exposed to atosiban, fenoterol and the combination of atosiban with fenoterol. Contractility was measured as area under the curve during 30 min of spontaneous contractions. The effect of treatment was expressed as the percentage of change from basal activity during 30 min of exposure. Differences were calculated using a paired Wilcoxon signed-rank test. An additive effect of dual tocolysis was assumed when no significant difference was detected between the observed and expected inhibition of dual tocolysis. When inhibition was greater or lower than expected, the dual combination was characterised as “synergistic” or “antagonistic”, respectively. Results Atosiban and fenoterol alone suppressed contractions by a median of 43.2% and 29.8%, respectively. The combination of atosiban plus fenoterol was measured at a level of 67.3% inhibition. There was no significant difference in the expected (63.2%) and observed inhibition effect of dual tocolysis (P=0.945). Conclusion This study demonstrated an additive effect of dual tocolysis of atosiban and fenoterol on human myometrium in vitro, but no synergistic or antagonistic effect.

Candidemia in Intensive Care Units Over Nine Years at a Large Italian University Hospital 

2020 ◽  
Author(s):  
Sara Mazzanti ◽  
Lucia Brescini ◽  
Gianluca Morroni ◽  
Elena Orsetti ◽  
Antonella Pocognoli ◽  
...  
Keyword(s):  
Intensive Care ◽  
Incidence Rate ◽  
Intensive Care Units ◽  
Antifungal Therapy ◽  
Bloodstream Infections ◽  
Mortality Rates ◽  
University Hospital ◽  
Related Factors ◽  
Icu Patients ◽  
Over Time

Abstract Purpose: Candidemia is an alarming problem in critically ill patients including those admitted in intensive care units (ICUs). We aimed to describe the clinical and microbiological characteristics of bloodstream infections (BSIs) due to Candida spp. in patients admitted to ICUs of an italian tertiary referral university hospital over nine years. Methods: A retrospective observational study of all cases of candidemia in adult patients was carried out from January 1, 2010 to December 31, 2018 at a 980-bedded University Hospital in Ancona, Italy, counting five ICUs. The incidence, demographics, clinical and microbiologic characteristics, therapeutic approaches and outcomes of ICU-patients with candidemia were collected. Early (7 days from the occurrence of the episode of Candida BSI) and late (30 days) mortality rates were calculated. Results: During the study period, 188/505 (36%) episodes of candidemia occurred in ICU patients. Incidence rate was 9.9/1000 ICU admission and it showed to be stable over time. Candida albicans accounted for 52% of the cases, followed by C. parapsilosis (24%), and C. glabrata (14%). With the exception of isolates of C. tropicalis which showed to be fluconazole resistant in 25% of the cases, resistance to antifungals was not of concern in our patients. Early and late mortality rates were 19% and 41%, respectively and did not increased significantly over time. Independent risk factors for higher mortality were septic shock, acute kidney failure, pulmonary embolism and lack of antifungal therapy. The type of antifungal therapy did not influence the outcome. Conclusion: Neither incidence rate nor crude mortality of candidemia in ICU patients increased over time at our institution. However, mortality rate remained high and significantly associated with specific host-related factors.

Abstract 116: Delta Neutrophil Index as a Useful Prognostic Marker in Pediatric Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Seo Hee Yoon ◽  
Jong Gyun Ahn
Keyword(s):  
Cardiac Arrest ◽  
Chest Compression ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Rank Test ◽  
Operating Characteristics ◽  
Survival Group ◽  
Probability Of Survival ◽  
Survivor Group ◽  
Delta Neutrophil Index

Introduction: Patients resuscitated after enduring cardiac arrest (CA) experience post-cardiac arrest syndrome, which mimics the physiologic derangement consistent with observations of severe sepsis. The delta neutrophil index (DNI), which reflects a fraction of circulating immature granulocytes, has been reported to be strongly associated with increased mortality in systemic inflammation, also in adult patients after CA. However, pediatric CA is different from adult CA in etiology or early pathophysiology. In this study we evaluated the prognostic significance of the DNI in terms of early mortality after CA in children. Methods: We retrospectively identified consecutive patients (≤18 years) with CA who received chest compression for ≥2 min from January of 2012 to January of 2018. Patients who survived at least 24 h after undergoing chest compression were included in the analysis. The DNI was determined on each day following the incidence of CA. The outcome of interest was the 30-day mortality. Results: A total of 85 patients who had a CA were included in the study (survival group; n=55, non-survival group; n=30). The median value of the DNI on day 1 (24 hours after CA) was 1.4% (interquartile range [IQR] 0-4.7%) in the survivor group, and 15.1% (IQR 6.7-28.7%) in the non-survivor group. The difference was statistically significant ( P < 0.001). The receiver operating characteristics analysis revealed a cut-off that predicted a 30 day-mortality, was a DNI on day 1 > 4.7% (area under the curve 0.816; 95% CI (0.713 to 0.895); P < 0.001). The Kaplan-Meier survival analysis revealed, the probability of survival was significantly lower in patients with DNI > 4.7% on day 1 (log-rank test; P < 0.001). Conclusions: The DNI level can be considered a useful indicator for predicting early prognosis in pediatric cardiac arrest patients

Defining Minor Intracerebral Hemorrhage

2021 ◽  
pp. 1-8
Author(s):  
Alejandra Gómez-González ◽  
Uxue Lazcano ◽  
Rosa Maria Vivanco-Hidalgo ◽  
Luis Prats-Sánchez ◽  
Daniel Guisado-Alonso ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
External Validation ◽  
Area Under The Curve ◽  
Cutoff Point ◽  
University Hospital ◽  
Minor Stroke ◽  
Operating Characteristics ◽  
Discovery Cohort ◽  
Definition Of ◽  
A Minor

<b><i>Background and Purpose:</i></b> The minor stroke concept has not been analyzed in intracerebral hemorrhage (ICH) patients. Our purpose was to determine the optimal cut point on the NIH Stroke Scale (NIHSS) for defining a minor ICH (mICH) in patients with primary ICH. <b><i>Methods:</i></b> An ICH was considered minor if associated with a favorable 3-month outcome (modified Rankin Scale score ≤2). For supratentorial ICH, the discovery cohort consisted of 478 patients prospectively admitted at University Hospital del Mar. Association between NIHSS at admission and 3-month outcome was evaluated with area under the curve-receiver operating characteristics (AUC-ROC) and Youden’s index to identify the optimal NIHSS cutoff point to define mICH. External validation was performed in a cohort of 242 supratentorial ICH patients from University Hospital Sant Pau. For infratentorial location, patients from both hospitals (<i>n</i> = 85) were analyzed together. <b><i>Results:</i></b> The best ­NIHSS cutoff point defining supratentorial-mICH was 6 (AUC-ROC = 0.815 [0.774–0.857] in the discovery cohort and AUC-ROC = 0.819 [0.756–0.882] in the external validation cohort). For infratentorial ICH, the best cutoff point was 4 (AUC-ROC = 0.771 [0.664–0.877]). Using these cutoff points, 40.5% of all primary ICH cases were mICH. Of these, 70.2% were living independently at 3-month follow-up (72% for supratentorial ICH and 56.1% for infratentorial ICH) and 6.5% had died (5.3% for supratentorial ICH, and 14.6% for infratentorial ICH). For patients identified as non-mICH, good 3-month outcome was observed in 11.3% of cases; mortality was 51%. <b><i>Conclusions:</i></b> The definition of mICH using the NIHSS cutoff point of 6 for supratentorial ICH and 4 for infratentorial ICH is useful to identify good outcome in ICH patients.

scholarly journals Time-to-Death Longitudinal Characterization of Clinical Variables and Longitudinal Prediction of Mortality in COVID-19 Patients: A Two-Center Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Anne Chen ◽  
Zirun Zhao ◽  
Wei Hou ◽  
Adam J. Singer ◽  
Haifang Li ◽  
...  
Keyword(s):  
Predictive Model ◽  
White Blood Cells ◽  
Area Under The Curve ◽  
University Hospital ◽  
Clinical Markers ◽  
Operating Characteristics ◽  
Hospital Data ◽  
Temporal Characteristics ◽  
Clinical Variables ◽  
Prediction Of Mortality

Objectives: To characterize the temporal characteristics of clinical variables with time lock to mortality and build a predictive model of mortality associated with COVID-19 using clinical variables.Design: Retrospective cohort study of the temporal characteristics of clinical variables with time lock to mortality.Setting: Stony Brook University Hospital (New York) and Tongji Hospital.Patients: Patients with confirmed positive for severe acute respiratory syndrome coronavirus-2 using polymerase chain reaction testing. Patients from the Stony Brook University Hospital data were used for training (80%, N = 1,002) and testing (20%, N = 250), and 375 patients from the Tongji Hospital (Wuhan, China) data were used for testing.Intervention: None.Measurements and Main Results: Longitudinal clinical variables were analyzed as a function of days from outcome with time-lock-to-day of death (non-survivors) or discharge (survivors). A predictive model using the significant earliest predictors was constructed. Performance was evaluated using receiver operating characteristics area under the curve (AUC). The predictive model found lactate dehydrogenase, lymphocytes, procalcitonin, D-dimer, C-reactive protein, respiratory rate, and white-blood cells to be early predictors of mortality. The AUC for the zero to 9 days prior to outcome were: 0.99, 0.96, 0.94, 0.90, 0.82, 0.75, 0.73, 0.77, 0.79, and 0.73, respectively (Stony Brook Hospital), and 1.0, 0.86, 0.88, 0.96, 0.91, 0.62, 0.67, 0.50, 0.63, and 0.57, respectively (Tongji Hospital). In comparison, prediction performance using hospital admission data was poor (AUC = 0.59). Temporal fluctuations of most clinical variables, indicative of physiological and biochemical instability, were markedly higher in non-survivors compared to survivors (p &lt; 0.001).Conclusion: This study identified several clinical markers that demonstrated a temporal progression associated with mortality. These variables accurately predicted death within a few days prior to outcome, which provides objective indication that closer monitoring and interventions may be needed to prevent deterioration.

scholarly journals Utility of a Bedside Pocket-Sized Ultrasound Device to Promptly Manage Abdominal Pain in the Emergency Department

2019 ◽  
Vol 1 (1) ◽  
pp. 13-21
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Imaging Modality ◽  
Low Cost ◽  
Tertiary Care ◽  
Area Under The Curve ◽  
Final Diagnosis ◽  
University Hospital ◽  
Operating Characteristics ◽  
Early Assessment

Introduction: Abdominal pain is a frequent reason for Emergency Department (ED) admission; it amounts for around 5–10% of all ED visits. Early assessment should focus on immediately distinguishing cases of acute abdomen that require urgent surgical intervention. The clinical localization of pain is crucial, suggesting an initial evaluation of the origin of the abdominal pain; however, imaging is often required for final diagnosis. Ultrasound (US) represents a rapid imaging modality that is readily available in the ED and does not involve radiation or contrast agent administration. A new generation of portable, battery-powered, low-cost, hand-carried ultrasound devices have become available recently; these devices can provide immediate diagnostic information in patients presenting with abdominal pain in ED.The aim of the study was to demonstrate the diagnostic usefulness of a bedside pocket-sized ultrasound (BPU) device (Vscan from General Electrics) in non-traumatic patients complaining of acute abdominal pain in a tertiary care university hospital in Italy. Methods: Patients with acute non-traumatic abdominal pain presenting in ED were prospectively enrolled and underwent physical examination, traditional imaging and BPU. Results: A total number of 230 patients with acute non-traumatic abdominal pain were enrolled. Overall agreement between routine standard imaging and BPU turned out to be equal for computed tomography (K=0.3) and traditional ultrasound (K=0.29). Receiver operating characteristics curve (ROC) analysis for diagnostic power of the BPU in comparison with traditional US showed an area under the curve of 0.65, sensitivity and specificity of 87.2% and 42.31% respectively. Conclusions: Emergency use of BPU in patients with non-traumatic abdominal pain demonstrated good diagnostic performance when compared to traditional imaging, with the potential advantage of reducing costs and delay in patient final disposition.

scholarly journals Fibrinogen–Albumin-Ratio is an independent predictor of thromboembolic complications in patients undergoing VA-ECMO

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sebastian Roth ◽  
Catrin Jansen ◽  
René M’Pembele ◽  
Alexandra Stroda ◽  
Udo Boeken ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Area Under The Curve ◽  
University Hospital ◽  
Youden Index ◽  
Thromboembolic Complications ◽  
Operating Characteristics ◽  
Albumin Ratio ◽  
Va Ecmo ◽  
The University ◽  
Ecmo Therapy

AbstractVeno-arterial extracorporeal membrane oxygenation (VA-ECMO) supports patients suffering from refractory cardiogenic shock. Thromboembolic complications (TeC) are common in VA-ECMO patients and are associated with increased morbidity and mortality. Valid markers to predict TeC in VA-ECMO patients are lacking. The present study investigated the predictive value of baseline Fibrinogen–Albumin-Ratio (FAR) for in-hospital TeC in patients undergoing VA-ECMO. This retrospective cohort study included patients who underwent VA-ECMO therapy due to cardiogenic shock at the University Hospital Duesseldorf, Germany between 2011 and 2018. Main exposure was baseline FAR measured at initiation of VA-ECMO therapy. The primary endpoint was the in-hospital incidence of TeC. In total, 344 patients were included into analysis (74.7% male, mean age 59 ± 14 years). The in-hospital incidence of TeC was 34%. Receiver operating characteristics (ROC) curve of FAR for in-hospital TeC revealed an area under the curve of 0.67 [95% confidence interval (CI) 0.61–0.74]. Youden index determined a cutoff of 130 for baseline FAR. Multivariate logistic regression revealed an adjusted odds-ratio of 3.72 [95% CI 2.26–6.14] for the association between FAR and TeC. Baseline FAR is independently associated with in-hospital TeC in patients undergoing VA-ECMO. Thus, FAR might contribute to the prediction of TeC in this cohort.

scholarly journals Diagnostic Accuracy of D-Dimers for Predicting Pulmonary Embolism in COVID-19-Patients

2021 ◽  
Vol 27 ◽  
pp. 107602962110579
Author(s):  
Falmata Laouan Brem ◽  
Boudouh Asmae ◽  
Yassine Amane ◽  
Mohammed-Amine Bouazzaoui ◽  
Miri Chaymae ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Symptoms ◽  
University Hospital ◽  
The Novel ◽  
Test Results ◽  
Operating Characteristics ◽  
Study Population ◽  
Novel Coronavirus ◽  
The University ◽  
D Dimer

Importance Proinflammatory and hypercoagulable states with marked elevation seen in D-Dimer levels have been accurately described in patients infected by the SARS- Cov2 even without pulmonary embolism (PE). Objectives To compare D-dimers values in patients infected by the novel Coronavirus 2019 (COVID-19) with and without PE and to establish an optimal D-dimer cut-off to predict the occurrence of PE, which guides pulmonary computed tomography angiography (CTPA) indication. Methods We retrospectively enrolled all COVID-19-patients admitted between October first and November 22th, 2020, at the University Hospital Center of Mohammed VI, Oujda (Morocco), suspected to have PE and underwent a CTPA. Demographic characteristics and blood test results were compared between PE-positive and PE-negative. The receiver operating characteristics (ROC) curve was constructed to establish an optimal D-Dimer cut-off to predict the occurrence of PE. Results The study population consisted of 84 confirmed COVID-19-patients. The mean age was 64.93 years (SD 14.19). PE was diagnosed on CTPA in 31 (36.9%) patients. Clinical symptoms and in-hospital outcomes were similar in both groups except that more men had PE ( p = .025). The median value of D-dimers in the group of patients with PE was significantly higher (14 680[IQR 33620-3450]ng/mL compared to the group of patients without PE 2980[IQR 6870-1600]ng/mL [P < .001]. A D-dimer at 2600 ng/mL was the optimal cut-off for predicting PE with a sensitivity of 90.3%, and AUC was .773[CI 95%, .667 −.876). Conclusion A D-dimer cut-off value of 2600 ng/mL is a significant predictor of PE in COVID-19-patients with a sensitivity of 90.3%.

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