SPC365

Staying too still: Pulmonary embolism during COVID-19 pandemic

Session: Posters - F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Speaker: Pedro Alves Da Silva

Congress: CPC 2021
Topic: F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme: 21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme: 21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type: Posters
FP Number: ---
Authors: Pedro Alves Da Silva; Beatriz Valente Silva; Tiago Rodrigues; Nelson Cunha; Sara Couto Pereira; Pedro Silvério António; Joana Brito; Ana Margarida Martins; Ana Beatriz Garcia; Catarina Oliveira; Rui Plácido; Fausto j. Pinto; Ana g. Almeida

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Background</span></strong><span style="color:black">:&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">During the COVID-19 pandemic many countries have entered lockdown and imposed restrictions to dislocations. Since the 18</span><sup><span style="font-size:6.5pt"><span style="color:black">th</span></span></sup><span style="color:black"> March, in Portugal, thousands of people have been confined to their homes. While hospital admissions for COVID-19 patients increased exponentially, admissions for non-COVID-19 patients decreased dramatically. However, it remains unclear whether lockdown-related immobility can contribute to the increased incidence of pulmonary embolism.&nbsp;</span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Purpose</span></strong><span style="color:black">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">To compare the incidence of pulmonary embolism (PE) during the lockdown period (from April 1 to May 31, 2020) and the reference period in 2019.&nbsp;</span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Methods</span></strong><span style="color:black">:</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Retrospective study of consecutive outpatients who presented to the emergency department of a tertiary hospital and underwent computed tomography pulmonary angiography (CTPA) due to suspicion of PE.&nbsp;</span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Results</span></strong><span style="color:black">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Compared to the same period of 2019, the lockdown period was associated with a significant increase (62%, p=0.012) in PE diagnosis (29 <em>vs</em> 18 patients). PE patients during lockdown were older (median age 71 years; interquartile range [IQR][60-85] <em>versus</em> 59 years [44-76]; p=0.046) and have lower prevalence of active cancer (14% v<em>ersus </em>33% in the reference period). Women represent 55% (n=16) of patients in lockdown group (<em>versus</em> 50% in 2019 group). Clinical probability (GENEVA score) was similar in both groups (median score 2.72 in lockdown group and 2.50 in reference group, p=0.452).&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">None of the patients with PE was diagnosed with COVID-19.&nbsp;</span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Conclusion</span></strong><span style="color:black">:</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Our study suggests a marked increase in PE diagnosis during lockdown period compared to the reference period, which can be explained by the overall reduction in physical activity due to teleworking and closure of gyms and sports activities.&nbsp;</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">These data reinforce the importance of promoting&nbsp; home-based physical activity programs. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Furthermore, the role of pharmacological or mechanical thromboprophylaxis in this scenario remains unclear and further studies will be needed to prove it.</span></span></span></p>