Prognosis of pulmonary embolism in patients with a new coronavirus infection

Authors: Kogan L.P., Fedorov S.A., Vol’vach A.E., Gordetsov A.S., Krasnikova O.V., Chiginev V.A., Grishina N.I.

Company: ¹ Nizhny Novgorod State University of Architecture and Civil Engineering, Nizhny Novgorod, Russian Federation
² Specialized Cardiosurgical Clinical Hospital named after academician B.A. Korolev, Nizhnу Novgorod, Russian Federation
³ Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation
⁴ Chuvash State University named after I.N. Ulyanov, Chuvash Republic, Cheboksary, Russian Federation
⁵ Crimean Astrophysical Observatory of the Russian Academy of Sciences, Republic of Crimea, Russian Federation

UDC: 616.131.005.7-022.7:616.98
DOI: https://doi.org/10.24022/1810-0694-2022-23-3-322-332

Cite as: Kogan L.P., Fedorov S.A., Vol’vach A.E., Gordetsov A.S., Krasnikova O.V., Chiginev V.A., Grishina N.I., Prognosis of pulmonary embolism in patients with a new coronavirus infection. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2022; 23 (3): 322–332 (in Russ.). DOI: 10.24022/1810-0694-2022-23-3-322-332

Received / Accepted: 20.05.2022 / 22.06.2022

Keywords: pulmonary embolism coronavirus infection

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Abstract

Introduction. Disorders of the coagulation system occupy one of the leading positions of the new coronavirus infection. Characterized by an unpredictable onset, they in most percent of cases lead to early decompensation and death of patients with a high morbid profile. Despite the presence of a large number of studies devoted to diagnosis and treatment, issues related to screening, early verification remain controversial and unresolved. The aim of the study was to evaluate the possibility of predicting the development of venous thromboembolic complication (VTE) in a group of patients against the background of a new coronavirus infection.

Material and methods. Our research is based on a mathematical analysis of protocols of publicly available laboratory and instrumental research methods taken from the case histories of patients undergoing inpatient treatment in COVID hospitals in Nizhny Novgorod. The total group of respondents included 45 patients, who were subsequently divided into two subgroups depending on the presence or absence of verifiable episodes of pulmonary emboly (PE). So, the first group consisted of 15 people who developed massive PE on the background of COVID-associated polysegmental pneumonia. The second group was represented by 30 respondents who had suffered pneumonia not complicated by the development of PE. It should be noted that all the patients presented had identical volumes of lung parenchyma lesion, had a similar premorbid status and belonged to an identical age-sex cohort.

Results. In the course of the study, mathematical processing of the material under consideration was carried out using Bayes' theorem and Fourier's theorem, which ultimately made it possible to determine the possibility of predicting the development of pulmonary embolism in the considered group of patients.

Conclusion. The presented data allow us to note that the identification of a high probability of the development of VTE according to general clinical laboratory data in patients with a new coronavirus infection will allow timely verification of the correct diagnosis, to argue the vector of further follow-up, as well as to accept the correct treatment option.

References

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***

CDC. 2019 Novel Coronavirus, Wuhan, China. CDC. Available at https://www.cdc.gov/coronavirus/2019-ncov/about/index.html (Accessed January 26, 2020).
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Miranda F., Arevalo-Rodriguez I., Díaz G., Gonzalez F., Plana M.N., Zamora J. et al. Confusion assessment method for the intensive care unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settings. Cochrane Database Syst. Rev. 2018; 2018 (9): CD013126. DOI: 10.1002/14651858.CD013126
Collinsworth A.W., Priest E.L., Campbell C.R., Vasilevskis E.E., Masica A.L. A review of multifaceted care approaches for the prevention and mitigation of delirium in intensive care units. J. Intensive Care Med. 2016; 31 (2): 127–41. DOI: 10.1177/0885066614553925. Epub 2014 Oct 27.
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Subramaniam B., Shankar P., Shaefi S., Mueller A., O'Gara B., Banner-Goodspeed V. et al. Effect of intravenous acetaminophen vs placebo combined with propofol or dexmedetomidine on postoperative delirium among older patients following cardiac surgery: The DEXACET Randomized Clinical Trial. JAMA. 2019; 321 (7): 686–96. DOI: 10.1001/jama.2019.0234. Erratum in: JAMA. 2019; 322 (3): 276.
Venn R.M., Bradshaw C.J., Spencer R., Brealey D., Caudwell E., Naughton C. et al. Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit. Anaesthesia. 1999; 54 (12): 1136–42. DOI: 10.1046/j.1365-2044.1999.01114.x
Turan A., Duncan A., Leung S., Karimi N., Fang J., Mao G. et al.; DECADE Study Group. Dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery (DECADE): a randomised placebocontrolled trial. Lancet. 2020; 396 (10245): 177–85. DOI: 10.1016/S0140-6736(20)30631-0
Gertler R., Brown H.C., Mitchell D.H., Silvius E.N. Dexmedetomidine: a novel sedative-analgesic agent. Proc. (Bayl Univ. Med. Cent.). 2001; 14 (1): 13–21. DOI: 10.1080/08998280.2001.11927725
Bhana N., Goa K.L., McClellan K.J. Dexmedetomidine. Drugs. 2000; 59 (2): 263–8; disc. 269–70. DOI: 10.2165/00003495-200059020-00012
Guo T.Z., Jiang J.Y., Buttermann A.E., Maze M. Dexmedetomidine injection into the locus ceruleus produces antinociception. Anesthesiology. 1996; 84 (4): 873–81. DOI: 10.1097/00000542-199604000-00015
Brown E.N., Lydic R., Schiff N.D. General anesthesia, sleep, and coma. N. Engl. J. Med. 2010; 363 (27): 2638–50. DOI: 10.1056/NEJMra0808281
Nelson L.E., Lu J., Guo T., Saper C.B., Franks N.P., Maze M. The alpha2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiology. 2003; 98 (2): 428–36. DOI: 10.1097/00000542-200302000-00024
Djaiani G., Silverton N., Fedorko L., Carroll J., Styra R., Rao V., Katznelson R. Dexmedetomidine versus propofol sedation reduces delirium after cardiac surgery: A randomized controlled trial. Anesthesiology. 2016; 124 (2): 362–8. DOI: 10.1097/ALN.0000000000000951
Ji F., Li Z., Nguyen H., Young N., Shi P., Fleming N., Liu H. Perioperative dexmedetomidine improves outcomes of cardiac surgery. Circulation. 2013; 127 (15): 1576–84. DOI: 10.1161/CIRCULATIONAHA.112. 000936. Epub 2013 Mar 19.
Wang G., Niu J., Li Z., Lv H., Cai H. The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis. PLoS One. 2018; 13 (9): e0202620. DOI: 10.1371/journal.pone.0202620
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Shi C., Jin J., Qiao L., Li T., Ma J., Ma Z. Effect of perioperative administration of dexmedetomidine on delirium after cardiac surgery in elderly patients: a doubleblinded, multi-center, randomized study. Clin. Interv. Aging. 2019; 14: 571–5. DOI: 10.2147/CIA.S194476
Azeem T.M.A., Yosif N.E., Alansary A.M., Esmat I.M., Mohamed A.K. Dexmedetomidine vs morphine and midazolam in the prevention and treatment of delirium after adult cardiac surgery; a randomized, double-blinded clinical trial. Saudi J. Anaesth. 2018; 12 (2): 190–7. DOI: 10.4103/sja.SJA_303_17
Lin C., Tu H., Jie Z., Zhou X., Li C. Effect of dexmedetomidine on delirium in elderly surgical patients: A meta-analysis of randomized controlled trials. Ann. Pharmacother. 2021; 55 (5): 624–36. DOI: 10.1177/1060028020951954. Epub 2020 Sep 4.

About the authors

Lev P. Kogan, Cand. Phys.-Math. Sci., Associate Professor of the Chair; ORCID
Sergey A. Fedorov, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
Aleksandr E. Vol’vach, Dr. Phys.-Math. Sci., Deputy Director for Scientific Work; ORCID
Aleksandr S. Gordetsov, Dr. Med. Sci., Professor, Head of the Department; ORCID
Ol’ga V. Krasnikova, Cand. Biol. Sci., Associate Professor of Chair; ORCID
Vladimir A. Chiginev, Dr. Med. Sci., Cardiovascular Surgeon; ORCID
Natal’ya I. Grishina, Clinical Resident; ORCID

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Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

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