TY - JOUR
T1 - A comparison of pulmonary embolism in pediatric and adult patients with acute COVID-19
AU - Hodes, Aaron D.
AU - Villasana-Gomez, Geraldine
AU - Traube, Leah
AU - Kurian, Jessica
AU - Liszewski, Mark C.
AU - Lazarus, Matthew S.
AU - Levin, Terry L.
AU - Blumfield, Einat
N1 - Funding Information:
The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. Dr. Mark C. Liszewski is an unpaid member of the Carestream Health Medical Advisory Board and receives grant support from Carestream Health for an unrelated study. Dr. Liszewski has received travel and meal support from Carestream Health. Dr. Einat Blumfield and her spouse are cofounders of Radnostics LLC of which the product is a software for automated segmentation of vertebral bodies in CT scans and automated screening for osteoporosis.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/5
Y1 - 2022/5
N2 - Background: COVID-19 is associated with pulmonary embolism (PE) in adults. However, the rate of PE in pediatric patients with acute COVID-19 evaluated by CT pulmonary angiography (CTPA) has not been evaluated. Objective: Determine PE rate in pediatric patients with acute COVID-19 and compare to adults. Materials and methods: A retrospective review of CTPA studies, performed between March 2020 and January 2021 on pediatric patients with acute COVID-19, but not MIS-C, was performed. CTPAs performed on an adult cohort of acute COVID-19 patients during April 2020 were reviewed for comparison. Pediatric and chest radiologists independently reviewed CTPAs of pediatric and adult patients, respectively. Results: Of the 355 acute COVID-19 pediatric patients treated during the study period, 14 (16.6 ± 4.8y, median-18.5y, 64% female) underwent CTPA. Of the 1868 acute COVID-19 adults treated during two weeks in April 2020, 50 (57.2 ± 17.0y, median-57.0y, 42% female) underwent CTPA. The PE rate was 14% in the pediatric group (2 patients) and 18% in the adult group (9 patients) (p = 1.0). Both pediatric patients with PE were obese, over 18y, and had asthma, diabetes mellitus, or hypertension. No child<18y with acute COVID-19 had PE. In the adult cohort, higher alanine-aminotransferase and D-dimer levels were associated with PE (p = 0.04 and p = 0.004, respectively). Conclusion: Despite similar PE rates in pediatric and adult patients, PE occurred in acute COVID-19 pediatric patients who were >18y, obese, and had at least 1 comorbidity. Children <18y with COVID-19 did not have PE.
AB - Background: COVID-19 is associated with pulmonary embolism (PE) in adults. However, the rate of PE in pediatric patients with acute COVID-19 evaluated by CT pulmonary angiography (CTPA) has not been evaluated. Objective: Determine PE rate in pediatric patients with acute COVID-19 and compare to adults. Materials and methods: A retrospective review of CTPA studies, performed between March 2020 and January 2021 on pediatric patients with acute COVID-19, but not MIS-C, was performed. CTPAs performed on an adult cohort of acute COVID-19 patients during April 2020 were reviewed for comparison. Pediatric and chest radiologists independently reviewed CTPAs of pediatric and adult patients, respectively. Results: Of the 355 acute COVID-19 pediatric patients treated during the study period, 14 (16.6 ± 4.8y, median-18.5y, 64% female) underwent CTPA. Of the 1868 acute COVID-19 adults treated during two weeks in April 2020, 50 (57.2 ± 17.0y, median-57.0y, 42% female) underwent CTPA. The PE rate was 14% in the pediatric group (2 patients) and 18% in the adult group (9 patients) (p = 1.0). Both pediatric patients with PE were obese, over 18y, and had asthma, diabetes mellitus, or hypertension. No child<18y with acute COVID-19 had PE. In the adult cohort, higher alanine-aminotransferase and D-dimer levels were associated with PE (p = 0.04 and p = 0.004, respectively). Conclusion: Despite similar PE rates in pediatric and adult patients, PE occurred in acute COVID-19 pediatric patients who were >18y, obese, and had at least 1 comorbidity. Children <18y with COVID-19 did not have PE.
KW - COVID-19
KW - CTPA
KW - Children
KW - Pediatric
KW - Pulmonary emboli
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U2 - 10.1016/j.clinimag.2022.02.015
DO - 10.1016/j.clinimag.2022.02.015
M3 - Article
C2 - 35220003
AN - SCOPUS:85125186448
SN - 0899-7071
VL - 85
SP - 10
EP - 13
JO - Clinical Imaging
JF - Clinical Imaging
ER -
