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Incidence and factors associated with pulmonary embolism among RT-PCR confirmed Covid-19 patients with upfront CT pulmonary angiography in Ethiopia: A nested casecontrol study


Eskedar Kebede Belayneh
Tigist Workneh Leulseged
Tewodros Kassahun Tarekegn
Efrata Sintayehu Teshome
Eden Efrem Mersiehazen
Kirubel Workiye Gebretsadik
Meron Mulugeta Arega
Yemesrach Fereja Mekonen
Adey Gizachew Alemayehu
Yonas Mebratu Gebrecherkos
Michael Aklilu Nega

Abstract

Introduction: Pulmonary embolism is one of the complications of COVID-19, with reported incidence ranging from 3 to 33 % in non-ICU patients to as  high as 40% among ICU patients. Since the clinical presentations of COVID-19 and Pulmonary embolism overlap, it is difficult to differentiate between  these cases. This study aimed to assess the incidence of pulmonary embolism and associated factors among confirmed Covid-19 Patients in Ethiopia.


Methods: A nested case control study was conducted among 131 patients with COVID-19 (40 COVID-19 patients with Pulmonary embolism and 91  COVID-19 patients with no PE) who were on follow up from May, 2021 to May, 2022. Data was summarized using frequencies with percentages. A chi- square test/ Fisher's exact test was run to determine the presence of a significant difference between the exposure variables and the development of PE.  To identify factors associated with the development of Pulmonary embolism, a multivariable Binary Logistic Regression model with sensitivity analysis  was run.


Results: The incidence of PE was 30.5% (95% CI, 22.9% - 37.4%) in the cohort of patients for whom upfront CTPA was performed. The Chi-square/ Fisher's exact test results showed a significantly higher proportion of patients with PE tend to present with shortness of breath, chest pain and  anosmia/ageusia than those with no PE. However, in a subsequent regression analysis, only chest pain was found to be significantly associated with the development of PE in COVID-19 patients (AOR= 3.24, 95% CI= 1.10, 9.54, p-value=0.033).


Conclusion: The incidence of PE among COVID-19 patients was  found to be relatively lower than reports from other countries. Having chest pain was found to be a significant factor that indicates the development of  PE, implying that in a setting where performing upfront CTPA is not practical, detailed symptom inquiry could serve as an important clinical criteria.  


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eISSN: 2415-2420
print ISSN: 0014-1755