ABSTRACT
Background: Pulmonary thromboembolism (PTE) is a common
complication of SARS-CoV-2, which raises the COVID-19 disease’s fatality
rate from 3% to 45%. Nevertheless, due to fairly indistinguishable
clinical symptoms and a lack of validated clinical prediction models,
PTE diagnosis in COVID-19 patients is challenging. This study aims to
investigate the applicability of hematological indices to predict PTE
incidence and its severity in SARS-CoV-2 patients.
Methods: A retrospective cohort study was conducted on
hospitalized patients with a confirmed diagnosis of SARS-CoV-2 infection
who underwent CT angiography to assess probable PTE in them. The
correlation between CBC parameters one day prior to CT angiography and
CT angiography outcomes, and simplified Pulmonary Embolism Severity
Index (s-PESI) was investigated.
Results: We discovered that among individuals with a probable
PTE, males and those with higher platelet-to-lymphocyte (PLR) and
neutrophil-to-lymphocyte (NLR) ratios had a greater likelihood of PTE
incidence. PLR was a significant and independent predictor of PTE.
Moreover, a higher neutrophil count was associated with a higher s-PESI
score in COVID-19 patients developing PTE.
Conclusions:Among
haematological indices, NLR and more precisely PLR are cost-effective
and simply calculable markers that can assist physicians in determining
whether or not COVID-19 patients with clinically probable PTE require CT
angiography and the higher neutrophil count can be employed as an
indicator of PTE severity in COVID-19 patients.
Further large multicenter and
prospective studies are warranted to corroborate these observations.
KEYWORDS: Pulmonary thromboembolism; SARS-CoV-2;
Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; PESI score