Comparison of pulmonary computed tomography angiography findings of COVID-19 cases with and without pulmonary thromboembolism

Since the coronavirus disease 2019 (COVID-19) pandemic, many patients have experienced pulmonary thromboembolism (PTE). In this study, we compared the findings of pulmonary computed tomography angiography (PCTA) in COVID-19 patients with and without PTE. This retrospective study included 168 patients who underwent PCTA. PCTA images were assessed for thromboembolic events, thromboembolism site, parenchymal involvement, severity and stage of involvement, and the computed tomography obstruction index. A total of 168 patients (84 with PTE and 84 without PTE), comprising 103 (61.3%) males with an average age of 59.03 years (95% confidence interval [CI]: 56.81-61.25), were included in the study. No significant differences were observed between the 2 groups in baseline characteristics, except for the mean age. The most common patterns were ground-glass opacities (GGO) (90.70%) and consolidation (44.70%). Age-adjusted logistic regression indicated that PTE patients were 4.5 times more likely to have GGO (P = .025, 95% CI: 1.21-16.9). Among patients with PTE, 57.8% had bilateral thromboembolism. Segmental and subsegmental artery involvement was more common in thromboembolic locations. The severity of lung involvement was significantly lower in the PTE group (median, 10; interquartile range, 11) than in the non-PTE group (median, 15; interquartile range, 10; P < .001). The average computed tomography obstruction index for patients with PTE was 6.96 (95% CI: 5.48-8.45). Neither intensive care unit admission nor survival rates showed significant differences between the groups (P = .618 for intensive care unit admission; P = .292 for survival rates). In conclusion, patients with COVID-19 complicated by PTE had higher odds of presenting with GGO. Segmental and subsegmental artery involvement were more common, and PTE did not significantly influence the patient's outcome.