{
  "abstract": "Background Acute pulmonary embolism (PE), one of the leading causes of cardiovascular mortality and sudden death, is a condition influenced by many factors, including age, comorbidities like obesity and lifestyle. 1 COVID-19 and vaccination have drawn great attention from their link to hypercoagulability, inducing both arterial and venous thrombosis.2–4 The role of modifiable factors like obesity in influencing changes in PE incidence during and after the pandemic is not well understood.Purpose To compare the incidence, clinical characteristics, and outcomes of acute pulmonary embolism in adults presenting to an acute secondary care hospital during the years before and after the COVID-19 pandemic, and to assess the potential impact of modifiable factors such as obesity on PE occurrence.Methods We retrospectively investigated all adult patients diagnosed with PE at our institution over 7 years (Oct 2016–Oct 2023). We divided the patients into two cohorts (pre- and post-COVID), referencing time zero as the onset of the declared SARS-COV-2 pandemic in the UK (March 2020) with an equal timeline on either side of this milestone. Demographics, comorbidities, multimodality investigations and clinical outcomes were compared between the two groups in a case-control fashion.Results Of the 2022 patients we screened, coded to have a diagnosis of PE, we included 1,423 who met diagnostic eligibility criteria; 517 were pre-COVID and 906 (63.7%) were post-COVID. While age (65.1 vs 63.8 years, p=0.082) and gender distributions (males; 48% pre vs 51% post COVID) were similar, the incidence of obesity was found to be significantly higher in the post-COVID cohort (27.7% in the pre- vs 34.4% in the post-COVID group, p=0.008). Moreover, active cancer rates in those presenting with PE declined by 10.3% in the post-pandemic years.Almost a third of patients in the post-COVID group (n= 268, 29.6%) had active COVID-19 infection, and 174 (19.2%) had received a COVID-19 vaccine within 3 months of PE diagnosis. Mean D-dimer levels were higher in the post-COVID cohort (86.2 µg/ml vs 5.64 µg/ml, p=0.05), accompanied by a rise in right ventricular strain (11.4% vs 17.4%, p=0.001). Pro-BNP and Troponin levels did not differ significantly between the groups. The need for mechanical ventilation, thrombolysis, rates of cardiac arrest, major haemorrhage, in-hospital mortality, and overall survival to discharge remained comparable.Conclusions In the post-COVID-19 years, non-malignancy-related PE rose 75%, despite an unchanged catchment area and demographics. Increased clot burden and right ventricular strain did not increase ICU admissions, major adverse events, or mortality. COVID-19–related thrombo-inflammatory effects, possibly combined with pandemic-related lifestyle changes (observed 7% increase in obesity), may have promoted a prothrombotic state, contributing to the rise in PE. Highlighting the importance of weight management in reducing future PE risk.Abstract 76 Table 1Abstract 76 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Syeda Asma Zahoor"
    },
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Loubna Faska"
    },
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Shamini Loganathan"
    },
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Vinay Dhilipkumar"
    },
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Veena Jayaramu"
    },
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Zubair Ahmed"
    },
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Hussain Nadeem"
    },
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Rishi Harith Nagamangala Sathisha"
    },
    {
      "affiliations": [
        "Manor Hospital, Walsall, United Kingdom"
      ],
      "name": "Nadia Sunni"
    }
  ],
  "title": "76 Comparative trends in acute pulmonary embolism before and after the COVID-19 pandemic and the impact of obesity: a UK retrospective case-control study",
  "uid": "a1529563-7dad-57ba-a431-72acb003911c"
}