Pulmonary Embolism in Pneumonia

Plućni embolizam (PE) i pneumonija dijele zajedničke rizične faktore, uzajamno se potenciraju i slično radiološki manifestiraju. Klinička slika pneumonije može u potpunosti maskirati prateću PE što uz porast D-dimera uslijed upalnog zbivanja znatno otežava probir pacijenata koje je potrebno podvrgnuti slikovnim metodama dijagnostike. Još uvijek nije pronađeno neko karakteristično obilježje (niti granična vrijednost D-dimera) koje bi direktno sugeriralo prisutnost PE u osobe s pneumonijom. Prateća PE najčešće se javlja u starijih i bolesnika s komorbiditetima, a bol u prsima, dispneja i sinkopa češće su nego kod pneumonije bez PE. Pojavnost PE u bolesnika s pneumonijom uzrokovanom novim koronavirusom (COVID-19) značajno je veća nego u pneumonija uzrokovanih drugim uzročnicima i povezuje se s rizičnim faktorima poput muškog spola, višim razinama C-reaktivnog proteina te odgodom hospitalizacije. Primjena profilaktičke doze antikoagulantne terapije može reducirati učestalost PE u bolesnika s COVID-19 pneumonijom.Pneumonia and pulmonary embolism (PE) share common risk factors, radiological findings and one disease may induce the development of another. The clinical characteristics of pneumonia can completely mask the concomitant PE, which, along with the increase in D-dimer due to inflammatory events, significantly complicates the screening of patients who need imaging diagnostic methods. A specific feature (including the exact D-dimer cut-off value), which would clearly indicate concomitant PE in pneumonia has not yet been established. However, older age, comorbidities, chest pain, dyspnea and syncope are more common in pneumonia with coexisting PE than in pneumonia alone. In new coronavirus associated pneumonia (COVID-19), PE is far more frequent than in pneumonia caused by other microorganisms. PE in COVID-19 pneumonia is associated with risk factors such as male sex, higher levels of C-reactive protein and delayed hospitalization. Anticoagulant-prophylaxis reduces the incidence of PE in COVID-19 pneumonia