A comparison of pulmonary embolism in pediatric and adult patients with acute COVID-19

Aaron D. Hodes, Geraldine Villasana-Gomez, Leah Traube, Jessica Kurian, Mark C. Liszewski, Matthew S. Lazarus, Terry L. Levin, Einat Blumfield

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)10-13
Number of pages4
JournalClinical Imaging
Volume85
DOIs
StatePublished - May 2022

Keywords

  • COVID-19
  • CTPA
  • Children
  • Pediatric
  • Pulmonary emboli

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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