CTA Can Help Pinpoint PE Risk in Obese Patients

May 18, 2020

Results show COVID-19-positive patients with BMI greater than 30 are at significantly higher PE risk.

Patients who are COVID-19-positive could benefit from being evaluated for pulmonary embolism (PE) with CT angiography (CTA). It can be particularly helpful for patients who are obese or who have high inflammation levels, new research has found.

In a study published in Radiology on May 14, a team of investigators led by Neo Poyiadi, M.D. a radiology resident at Henry Ford Health System, determined CTA could help providers render better medical care for patients at risk for developing PE. Based on the study results, they found patients with a body mass index (BMI) of more than 30 kg/m2 were 2.7 times more likely to experience the condition.

Because the body of evidence is growing around the thrombotic complications COVID-19 positive patients can develop, Poyiadi’s team wanted to determine what could make some patients more susceptible than others. To find the answer, the team evaluated the clinical characteristics of COVID-19-positive patients who also developed PE against those who did not.

Between March 16 and April 18, the team examined chest CT exams on 328 patients who tested positive for the virus with RT-PCR and had also undergone pulmonary CTA. In patient data, they looked for current PE, as well as evidence of a prior one, and they reviewed the patient records for a BMI greater than 30, D-dimer values, and statin use.

Of this patient group, the team determined 22 percent had PE. Those most at risk included patients who weighed more, individuals with higher mean C-reaction protein and mean D-dimer values, and non-intubated patients who needed oxygen prior to the CTA.

However, there was no statistically significant difference between patients who did and did not develop PE in terms of intensive care unit (ICU) admissions or the need for or duration of intubation. In fact, 72 percent of PE were identified in patients not admitted to the ICU, they said.

Overall, the team said, these results can help providers better determine the PE risk for a COVID-19-positive patient.

“Our study, in conjunction with recent and future studies, may prompt early evaluation with pulmonary CT angiography in COVID-19 patients who are at increased risk for developing pulmonary embolism based on demographic, clinical, and laboratory variables,” they wrote.