Elevated D-Dimer and acute pulmonary embolism in COVID-19 patients

espanolIntroduccion. Se ha determinado que los pacientes con infeccion por SARS-CoV-2 y neumonia severa con valores elevados de dimero-D, pueden desarrollar tromboembolismo pulmonar agudo (TEP) como complicacion, siendo una de las causas relacionada con la mortalidad en este grupo de pacientes. Material y metodos. Se realizo un analisis retrospectivo de 12 pacientes con diagnostico de infeccion por SARS-CoV-2 con alta sospecha clinica de APE confirmado por angio tomografia computarizada (AngioTC) y se describen los hallazgos descritos. Resultados. 12 pacientes con diagnostico de neumonia severa, dimero-D elevado 9,2 μg/ml (1,4 - ˃20 μg/ml) y confirmacion de infeccion de SARS-CoV-2 a traves de reaccion en cadena de polimerasa reversa (RT-PCR). Se objetivaron TEP principalmente en arterias segmentarias (75%) y arterias principales (25%). En el 100% de la muestra se objetivo neumonia con areas parcheadas de vidrio deslustrado bilaterales como hallazgo tipico de infeccion por SARS-CoV-2. Conclusion. La infeccion por SARS-CoV-2 esta relacionada con elevacion del dimero-D y con TEP. La angioTC determina el diagnostico, severidad y manejo oportuno (anticoagulacion) de los pacientes con TEP. Por tanto el angioTC debe ser considerado en todos los pacientes con dimero-D elevado o empeoramiento clinico. EnglishIntroduction. It has been determined that patients with SARS-CoV-2 infection and severe pneumonia with elevated D-dimer values can develop acute pulmonary thromboembolism (APE) as a complication, being one of the causes related to mortality in this group of patients. Methods. A retrospective analysis of 12 patients diagnosed with SARS-CoV-2 infection with high clinical suspicion of APE confirmed by computed tomography pulmonary angiopgraphy (CTPA) was performed and the described findings are described. Results. 12 patients with diagnosis of severe pneumonia, elevated D-dimer 9.2 μg / ml (1.4 - ˃20 μg / mL) and confirmation of SARS-CoV-2 infection through real-time reverse transcription polymerasa chain reaction (RT- PCR). APEs were observed mainly in segmental arteries (75%) and main arteries (25%). Pneumonia with patched areas of bilateral ground glass opacities was observed in 100% of the sample as a typical finding of SARS-CoV-2 infection. Conclusion. SARS-CoV-2 infection is related to elevation of D-dimer and APE. The CTPA determines the diagnosis, severity and timely management (anticoagulation) of patients with APE. Therefore CTPA should be considered in all patients with elevated D-dimer or clinical worsening.