{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T06:28:08Z","timestamp":1783232888004,"version":"3.54.6"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Emerging results indicate that, in COVID-19, thromboembolic complications contribute to the high mortality and morbidity. Previous research showed that the prevalence of pulmonary embolism (PE) is between 25\u201350% in COVID-19 patients, however, most of these reports are based on data from patients with severe pneumonia, treated in intensive care units.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>We conducted a retrospective, single-center, observational study to estimate the prevalence of PE in COVID-19 patients who underwent CT angiography and to identify the most important predictors.<\/jats:p>\n<jats:p>Adult outpatients with COVID-19, who presented at our COVID Outpatient Clinic between 1<jats:sup>st<\/jats:sup> and 31<jats:sup>st<\/jats:sup> of March in 2021 and underwent CTA examination were included in this study. Multiple linear regression analysis was used to identify predictors of PE in COVID-19 patients. The predictors were: age, gender, disease duration, CT severity index and log-transformed quantitative D-dimer (logQDDIM) value.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>843 COVID-19 patients were included into the study. 82.56% (693 patients) of the infected patients had a pulmonary CTA examination and D-dimer levels (mean age: 59.82 years \u00b1 15.66). 7.61% (53 patients) of the patients had PE. 2.02% (14 patients) of the patients had main branch or lobar PE.<\/jats:p>\n<jats:p>The multiple regression analysis found that only logQDDIM was a significant predictor. A logQDDIM cut-off value of 0.0169 (1.0171 ug\/ml serum D-dimer) predicted PE with 99% sensitivity (p&lt;0.0001, degree-of-freedom = 570, AUC = 0.72).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We demonstrated in a large cohort of COVID-19 patients that a cut-off value of QDDIM of 1ug\/ml can exclude pulmonary embolism in an outpatient setting, implicating that QDDIM might potentially supersede CTA as a screening approach in COVID-19 outpatient clinics.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0297023","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T18:30:10Z","timestamp":1705516210000},"page":"e0297023","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["D-dimer levels to exclude pulmonary embolism and reduce the need for CT angiography in COVID-19 in an outpatient population"],"prefix":"10.1371","volume":"19","author":[{"given":"Anita","family":"Kov\u00e1cs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00f3ra","family":"Hantosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikoletta","family":"Szab\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annam\u00e1ria","family":"Letoha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"Lengyel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imre","family":"F\u00f6ldesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katalin","family":"Buri\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e1s","family":"Palk\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e1niel","family":"Ver\u00e9b","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1442-4475","authenticated-orcid":true,"given":"Zsigmond Tam\u00e1s","family":"Kincses","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"issue":"1","key":"pone.0297023.ref001","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01365-2020","article-title":"Pulmonary embolism in patients with COVID-19 pneumonia","volume":"56","author":"F Bompard","year":"2020","journal-title":"Eur Respir J"},{"issue":"3","key":"pone.0297023.ref002","doi-asserted-by":"crossref","first-page":"E186","DOI":"10.1148\/radiol.2020201544","article-title":"Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected with Pulmonary CT Angiography.","volume":"296","author":"F Grillet","year":"2020","journal-title":"Radiology."},{"key":"pone.0297023.ref003","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.thromres.2020.04.041","article-title":"Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: An updated analysis","volume":"191","author":"FA Klok","year":"2020","journal-title":"Thromb Res"},{"key":"pone.0297023.ref004","article-title":"The sensitivity and specificity of chest CT in the diagnosis of COVID-19.","author":"A Kov\u00e1cs","year":"2020","journal-title":"Eur Radiol."},{"issue":"2","key":"pone.0297023.ref005","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1161\/CIRCULATIONAHA.120.047430","article-title":"Pulmonary Embolism in Patients With COVID-19: Awareness of an Increased Prevalence","volume":"142","author":"J Poissy","year":"2020","journal-title":"Circulation"},{"key":"pone.0297023.ref006","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.thromres.2020.04.024","article-title":"Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan","volume":"191","author":"C Lodigiani","year":"2020","journal-title":"Italy. 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