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    Oral Communication

    COVID

    Clinical Outcomes in COVID-19

    OC 29.2 - The impact of pulmonary embolism on the long-term health outcomes of COVID-19

    Sunday, June 25, 2023
    15:00 – 15:15 ET
    Room: 710A
    Session Available As: On-Demand

      Presenting Author(s)

    • Chantal Visser, MD

      PhD candidate, MD
      Department of Hematology, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
      Rotterdam, Zuid-Holland, Netherlands

      • Co-Author(s)

    • JB

      Julia C. Berentschot

      PhD Candidate, MD
      Department of Respiratory Medicine, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
      Rotterdam, Zuid-Holland, Netherlands

    • Cindy MM De Jong, MD

      MD, PhD student
      Department of Medicine - Thrombosis & Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
      Leiden, Zuid-Holland, Netherlands

    • MA

      M. Louisa Antoni

      Cardiologist, MD, PhD
      Department of Cardiology, Heart Lung Centre, Leiden University Medical Center, Leiden, the Netherlands
      Leiden, Zuid-Holland, Netherlands

    • RB

      Rita J.G. Berg-Emons, van den

      Associate Professor
      Department of Rehabilitation Medicine, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
      Rotterdam, Zuid-Holland, Netherlands

    • BB

      Bram Borst, van den

      Pulmonologist, MD, PhD
      Department of Pulmonary Diseases, Radboud University Medical Center, Radboud University, Nijmegen, the Netherlands
      Nijmegen, Gelderland, Netherlands

    • Hugo ten Cate, MD, PhD, FAHA (he/him/his)

      Professor, MD, PhD
      Thrombosis Expertise Center, Heart & Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands
      Maastricht, Limburg, Netherlands

    • At

      Arina J. ten Cate-Hoek

      Associate Professor, MD
      Thrombosis Expertise Center, Heart & Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands
      Maastricht, Limburg, Netherlands

    • DB

      Dionne Braeken

      Thrombosis Vigilance Officer, PhD
      Thrombosis Expertise Center, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
      Maastricht, Limburg, Netherlands

    • JG

      J.J. Miranda Geelhoed

      Pulmonologist, MD, PhD
      Department of Pulmonary Diseases, Leiden University Medical Centre, Leiden, The Netherlands
      Leiden, Zuid-Holland, Netherlands

    • MH

      Majanka Heijenbrok-Kal

      Clinical epidemiologist, PhD
      Department of Rehabilitation Medicine, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
      Rotterdam, Zuid-Holland, Netherlands

    • LK

      Lucia J.M. Kroft

      Radiologist, MD, PhD
      Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
      Leiden, Zuid-Holland, Netherlands

    • Jenneke Leentjens, MD, PhD (she/her/hers)

      Internist vascular medicine, MD, PhD
      Department of Internal Medicine, Radboud University Medical Center, Radboud University, Nijmegen, Netherlands
      Nijmegen, Gelderland, Netherlands

    • AR

      Anna H.E. Roukens

      Internist
      Department of Intensive Care, Leiden University Medical Center, Leiden, the Netherlands
      Leiden, Zuid-Holland, Netherlands

    • SC

      Suzanne C. Cannegieter, MD PhD

      Professor
      Department of Clinical Epidemiology, Leiden University Medical Center
      Leiden, Zuid-Holland, Netherlands

    • Erik Klok, MD, PhD, FESC

      Leiden University Medical Center

    • MH

      Merel E. Hellemons

      Pulmonologist, MD, PhD
      Department of Respiratory Medicine, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
      Rotterdam, Zuid-Holland, Netherlands

    • MK

      Marieke J.H.A. Kruip

      Associate professor, hematologist, MD, PhD
      Department of Hematology, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
      Rotterdam, Zuid-Holland, Netherlands

    Background: The incidence of pulmonary embolism (PE) in patients with COVID-19 has been reported to be remarkably high. However, its impact on the long-term health outcomes of COVID-19 patients is unknown.

    Aims: To compare pulmonary function and patient reported outcome measures (PROMs) between COVID-19 survivors with and without PE 3 months after hospital discharge.

    Methods: In this multicentre observational study, we aggregated data from existing databases on the follow-up of COVID-19 patients in 4 hospitals in the Netherlands. Health outcomes were evaluated at 3 months after hospitalization for COVID-19 by pulmonary function testing and PROMs. We evaluated the impact of PE on diffusing capacity of the lungs for carbon monoxide (DLCO) (% of predicted), anxiety and depression (HADS, GAD-7, and PHQ-9), cognitive status (CFQ), and health-related quality of life (HRQoL) (EQ-5D-5L) using logistic and linear multivariate models, adjusted for the predefined confounders of age at admission, sex, presence of comorbidities, and stay at intensive care unit. Approval was given by the Erasmus University Medical Centre’s ethics committee.

    Results: We included 465 COVID-19 patients, of whom 102 (21.9%) had developed PE during admission (Table 1). At 3 months follow-up, patients with PE had significantly more impairment in pulmonary function and lower HRQoL than patients without PE (Table 2). After adjusting for confounders, the association between PE and lower HRQoL remained (β=-0.069, 95% CI (-0.12 to -0.017), p=0.009). However, no association was observed between PE and DLCO values after adjustment (β=-2.0, 95% CI (-6.5 to 2.4), p=0.367). Similarly, no association between the psychological outcomes and PE was observed after adjustment (data not shown).

    Conclusion(s): We found evidence for a possible association between PE and lower HRQoL 3 months after hospitalization, scoring below the Dutch reference values. No evidence for an effect of PE on impaired diffusion capacity and psychological outcomes was observed.

    Learning Objectives:

    • Upon completion, participant will be able to recognize that COVID-19 patients with PE during hospitalization have lower pulmonary function outcomes than patients without PE 3 months after hospitalization
    • Upon completion, participant will be able to recognize that COVID-19 patients with PE during hospitalization have health related quality of life than patients without PE 3 months after hospitalization
    • Upon completion, participant will be able to appreaciate that some evidence for a possible causal effect of PE on HRQoL can be seen, but none for a causal effect of PE on pulmonary function outcomes.