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Early warning triad for pulmonary microemboli in COVID-19 pneumonia: Pulmonary artery diameter, D-dimer and NT-proBNP

Mustafa Timurkaan, Gulsum Altuntas, Mehmet Kalayci, Esra Suay Timurkaan, Hakan Ayyildiz.




Abstract

In COVID-19 patients, thrombotic and fibrinolytic events due to hyperinflammation coexist. This causes enlargement of the pulmonary artery trunk, increased D-dimer and proBNP levels. We studied the correlation of PAD, D-dimer, and NT-proBNP levels. We saw that microemboli can be predicted by using this correlation. 908 patients treated due to Covid-19 were included in the study. The patients were divided into two groups as survivors and mortal and divided into 4 groups according to lung involvement. Demographic, laboratory, and CT data were obtained from the hospital data recording system. When comparing inflammatory parameters, D-Dimer, PAD, NT-proBNP levels, we detected a significant difference between groups. There was a positive correlation between D-dimer, PAD, and NT-proBNP levels. Lung involvement more than 50% significantly increased mortality. The diagnosis of PE in patients with COVID-19 has vital importance. Rapid, reliable, non-invasive, easily accessible and low-cost tests are important in diagnosis. We predict that PAD and concurrent D-dimer with NT-proBNP elevation will enable earlier detection of pulmonary microemboli, determine mortality and prognosis, and help to regulate anticoagulation treatments earlier.

Key words: COVID-19, pulmonary embolism, pulmonary artery diameter, d-dimer, proBNP






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