array:24 [
  "pii" => "S2531043720301859"
  "issn" => "25310437"
  "doi" => "10.1016/j.pulmoe.2020.07.013"
  "estado" => "S300"
  "fechaPublicacion" => "2021-05-01"
  "aid" => "1533"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "cor"
  "cita" => "Pulmonol. 2021;27:261-3"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2531043720301021"
    "issn" => "25310437"
    "doi" => "10.1016/j.pulmoe.2020.04.019"
    "estado" => "S300"
    "fechaPublicacion" => "2021-05-01"
    "aid" => "1488"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Pulmonol. 2021;27:264-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Are patients with autoimmune disorders eligible for immunotherapy&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "264"
          "paginaFinal" => "266"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "D&#46; Madama, A&#46; Pego"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Madama"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Pego"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043720301021?idApp=UINPBA00004E"
    "url" => "/25310437/0000002700000003/v1_202105020809/S2531043720301021/v1_202105020809/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S253104372030146X"
    "issn" => "25310437"
    "doi" => "10.1016/j.pulmoe.2020.06.009"
    "estado" => "S300"
    "fechaPublicacion" => "2021-05-01"
    "aid" => "1514"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Pulmonol. 2021;27:260-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Prevention measures for COVID-19 in retail food stores in Braga&#44; Portugal"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "260"
          "paginaFinal" => "261"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; Precioso, C&#46; Samorinha, R&#46; Alves"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Precioso"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Samorinha"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Alves"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S253104372030146X?idApp=UINPBA00004E"
    "url" => "/25310437/0000002700000003/v1_202105020809/S253104372030146X/v1_202105020809/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Pulmonary artery thrombosis in COVID-19 patients"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "261"
        "paginaFinal" => "263"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A&#46; Graziani, M&#46; Domenicali, G&#46; Zanframundo, F&#46; Palmese, B&#46; Caroli, L&#46; Graziani"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Graziani"
            "email" => array:1 [
              0 => "alessandro.graziani@auslromagna.it"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Domenicali"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "G&#46;"
            "apellidos" => "Zanframundo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Palmese"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "B&#46;"
            "apellidos" => "Caroli"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Graziani"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Medicina Interna&#44; Ospedale Santa Maria delle Croci&#44; Viale Randi 48121&#44; Ravenna&#44; Italy"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Universit&#224; degli Studi di Bologna&#44; Italy"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Universit&#224; Cattolica Del Sacro Cuore&#44; Roma&#44; Italy"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 527
            "Ancho" => 1505
            "Tamanyo" => 123044
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed Tomography Pulmonary Angiography &#40;CTPA&#41; described signs of Pulmonary Artery Thrombosis &#40;PAT&#41; involved the lower pulmonary branches &#40;yellow arrows&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Arising in China in the winter of 2019&#44; COVID-19 &#40;caused by the SARS-CoV-2 virus&#41; has caused a global pandemic and severely stressed medical systems across the world&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Although knowledge about this novel coronavirus is still emerging&#44; the most common reason for hospitalization of COVID-19 patients is severe respiratory distress&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">COVID-19 has been accurately described as the cause for a proinflammatory and hypercoagulable state with marked elevations seen in Lactate Dehydrogenase&#44; Ferritin&#44; C-reactive protein&#44; D-Dimer&#44; and Interleukin levels&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The inflammatory response&#44; including production of inflammatory cells and cytokines&#44; induces a procoagulant effect and diffuse endothelial damage that predisposes thrombotic vascular lesions and Disseminated Intravascular Coagulation &#40;DIC&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">D-Dimer is related to the severity of the disease and an increased value is associated with the worst&#46; prognosis&#46; Retrospective studies demonstrated that patients admitted to Intensive Care Unit &#40;ICU&#41; had an elevated D Dimer value and&#44; in this setting&#44; some Authors recommended a therapeutic heparin doses for the patients with higher values&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">A recent ICU observation reported an increased risk of Pulmonary Embolism &#40;PE&#41; in COVID-19 compared to the historical control group even in patients that had undergone the Low Molecular Weight Heparin &#40;LMWH&#41; prophylaxis&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">We evaluated 138 patients with COVID 19 admitted to our Institution between March 2020 and May 2020&#46; All patients were COVID 19 positive according to clinical diagnostic criteria reverse-transcription&#8211;polymerase chain-reaction &#40;RT-PCR&#41; and Chest Thoracic tomography&#46; On admission&#44; most of them were haemodynamically stable &#40;78&#37;&#41; and febrile &#40;87&#37;&#41;&#46; During hospitalization&#44; some developed progressive respiratory failure and received oxygen supplementation &#40;41&#37;&#41;&#46; Four of them were started on Continuous Positive Airways Pressure &#40;CPAP&#41; but two died because of worsening Respiratory Failure&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">All patients were treated with hydroxycloroquine &#40;400&#8239;mg&#47;day&#41;&#44; darunavir&#47;ritonavir &#40;800&#47;100&#8239;mg&#47;day&#41; and enoxaparin &#40;4000&#8239;UI&#47;day&#41;&#46; Some patients &#40;26&#8239;pts&#41; received additional therapy with IL-6 and IL-1 antagonist &#40;20&#37;&#41;&#46; Every three days after their hospitalization&#44; laboratory exams with inflammatory and coagulation parameters &#40;INR&#44; activated partial thromboplastin time&#44; platelets count&#44; fibrinogen&#44; D-Dimer&#41; were repeated&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In patients with progressive elevation of D-Dimer of over three times the normal value &#40;from 1822 to 5911&#8239;&#956;g&#47;mL&#41;&#44; we performed a Computed Tomography Pulmonary Angiography &#40;CTPA&#41; and a Doppler Ultrasound &#40;DU&#41; of the lower limbs&#46; The tests were done during the second week of their hospitalization &#40;12&#44;3&#8239;&#177;&#8239;3&#44;2 days&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We identified eleven patients with high D-Dimer value&#44; nine of them &#40;6&#44;7&#37;&#41; had signs of Pulmonary Artery Thrombosis &#40;PAT&#41; without Deep Venous Thrombosis &#40;DVT&#41;&#46; The lesions were distributed bilaterally at the lower arterial branches &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; None of the nine patients experienced an objective respiratory worsening and those in oxygen therapy &#40;5 patients&#41; maintained a constant flow&#46; Therapeutic anticoagulation was started with subcutaneous enoxaparin &#40;1&#8239;mg&#47;kg&#41; twice daily&#44; followed by warfarin&#46; All patients were discharged home&#58; length of hospital stay &#40;LOS&#41; 21&#44;1&#8239;&#177;&#8239;3&#44;7 days&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">In <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> the laboratory parameters were compared between patients with and without PAT&#58; five days after admission&#44; only D-Dimer value and lymphocyte count were significatively different between the two groups&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Parameters are expressed as mean &#177; SD and statistically evaluated by Student T test&#46; P&#8239;&#60;&#8239;0&#44;05 was considered statistically significant&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Coagulopathic disorders are significantly increased in COVID-19 patients&#44; especially among those with severe disease&#46; Several mechanisms combine systemic inflammation with alterations of coagulation in COVID 19 patients&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In severe or critically ill patients&#44; the endothelial cells are damaged and release a large amount of inflammatory mediators that may predispose vascular thrombosis&#46; A study performed in ICU setting reported an increased risk of Pulmonary Embolism &#40;PE&#41; in COVID-19 patients treated with Low Molecular Weight Heparin &#40;LMWH&#41; prophylaxis compared to the historical COVID 19 negative control group&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Another Study reported that the prevalence of Venous Thromboembolism Events &#40;VTE&#41; was higher in ICU compared to general wards patients&#58; 47&#37; vs 3&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">High blood values of the procoagulant factor levels including fibrinogen and D-dimers have been associated with the worst prognosis and higher mortality&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Kaminetzky and coworkers compared the results of a cohort of 62 patients who underwent CTPA for suspected PE prior to the first case of COVID 19&#44; with 62 patients COVID 19 positive&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> CTPA was positive for PE in 37&#37; of COVID 19 patients &#40;14&#44;5&#37; in pre COVID patients&#41;&#44; D-Dimer was associated with a higher prevalence of thromboembolic events and correlated with the degree of PE severity&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In a group of patients admitted to non-ICU wards&#44; DU failed to detect DVT independently of the severity of their condition and length of in-hospital bed rest&#46; The Authors observed that this is apparently in contrast with the relatively frequent reports of PE in hospitalized COVID-19 patients It is possible that local thrombi in the lungs may be the cause of pulmonary arterial manifestations&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44; 11</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In this paper we reported COVID-19 patients with interstitial pneumonia admitted in our non-ICU Ward&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">During the course of hospitalization&#44; in eleven of them&#44; we observed a progressive increase of D-Dimer over three times the normal value&#44; associated with low or normal values of other coagulation or inflammatory blood parameters &#40;CRP&#44; LDH&#44; Ferritin&#44; fibrinogen&#44; INR&#44; aPTT&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Nine CTPA demonstrated a distal thrombosis of the lower pulmonary arterial branches&#46; The mainly basal localization where the pulmonary inflammation is most diffuse and the loss of signs of DVT may suggest a pulmonary thrombosis rather than an embolism&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">It is noteworthy that no patients had any signs of respiratory worsening and some of them did not receive oxygen therapy and they were breathing room air&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; we described patients with moderate disease who developed a pulmonary vascular injury strictly correlated with an elevation of D-Dimer values&#46; This parameter may help clinicians in identifying COVID-19 stable patients at risk of concurrent pulmonary artery thrombosis&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Further studies will need to better define the meaning of these preliminary observations&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 527
            "Ancho" => 1505
            "Tamanyo" => 123044
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed Tomography Pulmonary Angiography &#40;CTPA&#41; described signs of Pulmonary Artery Thrombosis &#40;PAT&#41; involved the lower pulmonary branches &#40;yellow arrows&#41;&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All Pts admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PAT pts admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All pts 5 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PAT pts 5 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All Pts 10 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PAT pts 10 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C-Reactive Proteine &#40;mg&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;6&#8239;&#177;&#8239;58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;6&#8239;&#177;&#8239;58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;9 &#177; 65&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;6&#8239;&#177;&#8239;58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;0 &#177; 25&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;5&#8239;&#177;&#8239; 27&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lymphocite &#40;mmc&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1294&#8239;&#177;&#8239;761&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1260 &#177; 414&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1465 &#177; 657&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1075 &#177; 219&#44;2<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1762 &#177; 858&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1290 &#177; 336&#44;7<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Platelets &#40;mmc&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">250&#44;000&#8239;&#177;&#8239;84&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">263&#44;000 &#177; 147&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">300&#44;000 &#177; 114&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">252&#44;800 &#177; 52&#44;900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">352&#44;300 &#177; 102&#44;900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">289&#44;000 &#177; 113&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fibrinogen &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">432&#44;3&#8239;&#177;&#8239;114&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">530 &#177; 121&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">428&#44;5 &#177; 138&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">426&#44;0 &#177; 14&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">379&#44;6 &#177; 100&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">466&#44;1 &#177; 142&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDH &#40;U&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">264&#44;4&#8239;&#177;&#8239;101&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">326&#44;2 &#177; 121&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">295&#44;2 &#177; 120&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">314&#44;5 &#177; 37&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">264&#44;0 &#177; 73&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">309 &#177; 63&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">INR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1 &#177; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#177; 0&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;05 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D-Dimer Ug&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">465&#44;1&#8239;&#177;&#8239;121&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">627&#44;4 &#177; 178&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">538&#44;3 &#177; 102&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2143&#44;6 &#177; 327&#44;5<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">576&#44;9 &#177; 169&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1764&#44;9 &#177; 227&#44;5<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2586803.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">P&#8239;&#60;&#8239;0&#44;05&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Laboratory parameters in patients with Pulmonary Artery Thrombosis &#40;PAT&#41; and the patients without PAT&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus&#8211;infected pneumonia in Wuhan&#44; China"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Wang"
                            1 => "B&#46; Hu"
                            2 => "C&#46; Hu"
                            3 => "Z&#46; Fangfang"
                            4 => "L&#46; Xing"
                            5 => "Z&#46; Jing"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2020.1585"
                      "Revista" => array:7 [
                        "tituloSerie" => "JAMA&#46;"
                        "fecha" => "2020"
                        "volumen" => "323"
                        "numero" => "11"
                        "paginaInicial" => "1061"
                        "paginaFinal" => "1069"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32031570"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thromboinflammation and the hypercoagulability of COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;M&#46; Connors"
                            1 => "J&#46;H&#46; Levy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jth.14849"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Thromb Haemost&#46;"
                        "fecha" => "2020"
                        "volumen" => "18"
                        "numero" => "7"
                        "paginaInicial" => "1559"
                        "paginaFinal" => "1561"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32302453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ematological findings and complications of COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Terpos"
                            1 => "I&#46; Ntanasis-Stathopoulos"
                            2 => "I&#46; Elalamy"
                            3 => "E&#46; Kastritis"
                            4 => "T&#46;N&#46; Sergentanis"
                            5 => "M&#46; Politou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ajh.25829"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Ematol&#46;"
                        "fecha" => "2020"
                        "volumen" => "95"
                        "numero" => "7"
                        "paginaInicial" => "834"
                        "paginaFinal" => "847"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46; Tang"
                            1 => "H&#46; Bai"
                            2 => "X&#46; Chen"
                            3 => "J&#46; Gong"
                            4 => "D&#46; Li"
                            5 => "Z&#46; Sun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jth.14817"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Thromb Haemost&#46;"
                        "fecha" => "2020"
                        "volumen" => "18"
                        "numero" => "5"
                        "paginaInicial" => "1094"
                        "paginaFinal" => "1099"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32220112"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathological findings of COVID-19 associated with acute respiratory distress syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46; Xu"
                            1 => "L&#46; Shi"
                            2 => "Y&#46; Wang"
                            3 => "J&#46; Zhang"
                            4 => "L&#46; Huang"
                            5 => "C&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2213-2600(20)30076-X"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Resp Med&#46;"
                        "fecha" => "2020"
                        "volumen" => "8"
                        "numero" => "4"
                        "paginaInicial" => "420"
                        "paginaFinal" => "422"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Lillicrap"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jth.14781"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Thromb Haemost&#46;"
                        "fecha" => "2020"
                        "volumen" => "18"
                        "numero" => "Apr &#40;4&#41;"
                        "paginaInicial" => "786"
                        "paginaFinal" => "787"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32212240"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary embolism in COVID-19 patients&#58; awareness of an increased prevalence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Poissy"
                            1 => "J&#46; Goutay"
                            2 => "M&#46; Morgan Caplan"
                            3 => "E&#46; Parmentier"
                            4 => "T&#46; Duburqc"
                            5 => "F&#46; Lassalle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.120.047430"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circulation&#46;"
                        "fecha" => "2020"
                        "volumen" => "142"
                        "paginaInicial" => "184"
                        "paginaFinal" => "186"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of venous thromboembolism in hospitalized patients with COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Middeldorp"
                            1 => "M&#46; Coppens"
                            2 => "T&#46;F&#46; Van Haaps"
                            3 => "M&#46; Foppen"
                            4 => "A&#46;P&#46; Vlaar"
                            5 => "M&#46; M&#252;ller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jth.14888"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Thromb Haemost&#46;"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary embolism on CTPA in COVID-19 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Kaminetzky"
                            1 => "W&#46; Moore"
                            2 => "K&#46; Fansiwala"
                            3 => "J&#46;S&#46; Babb"
                            4 => "D&#46; Kaminetky"
                            5 => "L&#46;I&#46; Horowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/ryct.2020200308"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiothoracic Imaging&#46;"
                        "fecha" => "2020"
                        "volumen" => "2"
                        "numero" => "4"
                        "paginaInicial" => "220"
                        "paginaFinal" => "229"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of thrombotic complications in critically ill ICU patients with COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;A&#46; Klok"
                            1 => "M&#46;J&#46;H&#46;A&#46; Kruip"
                            2 => "N&#46;J&#46;M&#46; van der Meer"
                            3 => "M&#46;S&#46; Arbous"
                            4 => "P&#46;J&#46; Gommers"
                            5 => "K&#46;M&#46; Kant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.thromres.2020.04.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thromb Res&#46;"
                        "fecha" => "2020"
                        "volumen" => "191"
                        "paginaInicial" => "145"
                        "paginaFinal" => "147"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32291094"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary embolism or pulmonary thrombosis in COVID-19&#63; Is the recommendation to use high-dose heparin for thromboprophylaxis justified&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Cattaneo"
                            1 => "E&#46;M&#46; Bertinato"
                            2 => "S&#46; Birocchi"
                            3 => "C&#46; Brizio"
                            4 => "D&#46; Malavolta"
                            5 => "M&#46; Manzoni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0040-1712097"
                      "Revista" => array:3 [
                        "tituloSerie" => "Thromb Haemost&#46;"
                        "fecha" => "2020"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9157595"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/25310437/0000002700000003/v1_202105020809/S2531043720301859/v1_202105020809/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "72880"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/25310437/0000002700000003/v1_202105020809/S2531043720301859/v1_202105020809/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043720301859?idApp=UINPBA00004E"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
Pulmonary artery thrombosis in COVID-19 patients
A. Graziania,
Corresponding author
, M. Domenicalia,b, G. Zanframundoa, F. Palmesea, B. Carolia, L. Grazianic
a Medicina Interna, Ospedale Santa Maria delle Croci, Viale Randi 48121, Ravenna, Italy
b Università degli Studi di Bologna, Italy
c Università Cattolica Del Sacro Cuore, Roma, Italy
Read
8696
Times
was read the article
2533
Total PDF
6163
Total HTML
Share statistics
 array:24 [
  "pii" => "S2531043720301859"
  "issn" => "25310437"
  "doi" => "10.1016/j.pulmoe.2020.07.013"
  "estado" => "S300"
  "fechaPublicacion" => "2021-05-01"
  "aid" => "1533"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "cor"
  "cita" => "Pulmonol. 2021;27:261-3"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2531043720301021"
    "issn" => "25310437"
    "doi" => "10.1016/j.pulmoe.2020.04.019"
    "estado" => "S300"
    "fechaPublicacion" => "2021-05-01"
    "aid" => "1488"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Pulmonol. 2021;27:264-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Are patients with autoimmune disorders eligible for immunotherapy&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "264"
          "paginaFinal" => "266"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "D&#46; Madama, A&#46; Pego"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Madama"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Pego"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043720301021?idApp=UINPBA00004E"
    "url" => "/25310437/0000002700000003/v1_202105020809/S2531043720301021/v1_202105020809/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S253104372030146X"
    "issn" => "25310437"
    "doi" => "10.1016/j.pulmoe.2020.06.009"
    "estado" => "S300"
    "fechaPublicacion" => "2021-05-01"
    "aid" => "1514"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Pulmonol. 2021;27:260-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Prevention measures for COVID-19 in retail food stores in Braga&#44; Portugal"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "260"
          "paginaFinal" => "261"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; Precioso, C&#46; Samorinha, R&#46; Alves"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Precioso"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Samorinha"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Alves"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S253104372030146X?idApp=UINPBA00004E"
    "url" => "/25310437/0000002700000003/v1_202105020809/S253104372030146X/v1_202105020809/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Pulmonary artery thrombosis in COVID-19 patients"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "261"
        "paginaFinal" => "263"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A&#46; Graziani, M&#46; Domenicali, G&#46; Zanframundo, F&#46; Palmese, B&#46; Caroli, L&#46; Graziani"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Graziani"
            "email" => array:1 [
              0 => "alessandro.graziani@auslromagna.it"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Domenicali"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "G&#46;"
            "apellidos" => "Zanframundo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Palmese"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "B&#46;"
            "apellidos" => "Caroli"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Graziani"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Medicina Interna&#44; Ospedale Santa Maria delle Croci&#44; Viale Randi 48121&#44; Ravenna&#44; Italy"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Universit&#224; degli Studi di Bologna&#44; Italy"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Universit&#224; Cattolica Del Sacro Cuore&#44; Roma&#44; Italy"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 527
            "Ancho" => 1505
            "Tamanyo" => 123044
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed Tomography Pulmonary Angiography &#40;CTPA&#41; described signs of Pulmonary Artery Thrombosis &#40;PAT&#41; involved the lower pulmonary branches &#40;yellow arrows&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Arising in China in the winter of 2019&#44; COVID-19 &#40;caused by the SARS-CoV-2 virus&#41; has caused a global pandemic and severely stressed medical systems across the world&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Although knowledge about this novel coronavirus is still emerging&#44; the most common reason for hospitalization of COVID-19 patients is severe respiratory distress&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">COVID-19 has been accurately described as the cause for a proinflammatory and hypercoagulable state with marked elevations seen in Lactate Dehydrogenase&#44; Ferritin&#44; C-reactive protein&#44; D-Dimer&#44; and Interleukin levels&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The inflammatory response&#44; including production of inflammatory cells and cytokines&#44; induces a procoagulant effect and diffuse endothelial damage that predisposes thrombotic vascular lesions and Disseminated Intravascular Coagulation &#40;DIC&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">D-Dimer is related to the severity of the disease and an increased value is associated with the worst&#46; prognosis&#46; Retrospective studies demonstrated that patients admitted to Intensive Care Unit &#40;ICU&#41; had an elevated D Dimer value and&#44; in this setting&#44; some Authors recommended a therapeutic heparin doses for the patients with higher values&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">A recent ICU observation reported an increased risk of Pulmonary Embolism &#40;PE&#41; in COVID-19 compared to the historical control group even in patients that had undergone the Low Molecular Weight Heparin &#40;LMWH&#41; prophylaxis&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">We evaluated 138 patients with COVID 19 admitted to our Institution between March 2020 and May 2020&#46; All patients were COVID 19 positive according to clinical diagnostic criteria reverse-transcription&#8211;polymerase chain-reaction &#40;RT-PCR&#41; and Chest Thoracic tomography&#46; On admission&#44; most of them were haemodynamically stable &#40;78&#37;&#41; and febrile &#40;87&#37;&#41;&#46; During hospitalization&#44; some developed progressive respiratory failure and received oxygen supplementation &#40;41&#37;&#41;&#46; Four of them were started on Continuous Positive Airways Pressure &#40;CPAP&#41; but two died because of worsening Respiratory Failure&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">All patients were treated with hydroxycloroquine &#40;400&#8239;mg&#47;day&#41;&#44; darunavir&#47;ritonavir &#40;800&#47;100&#8239;mg&#47;day&#41; and enoxaparin &#40;4000&#8239;UI&#47;day&#41;&#46; Some patients &#40;26&#8239;pts&#41; received additional therapy with IL-6 and IL-1 antagonist &#40;20&#37;&#41;&#46; Every three days after their hospitalization&#44; laboratory exams with inflammatory and coagulation parameters &#40;INR&#44; activated partial thromboplastin time&#44; platelets count&#44; fibrinogen&#44; D-Dimer&#41; were repeated&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In patients with progressive elevation of D-Dimer of over three times the normal value &#40;from 1822 to 5911&#8239;&#956;g&#47;mL&#41;&#44; we performed a Computed Tomography Pulmonary Angiography &#40;CTPA&#41; and a Doppler Ultrasound &#40;DU&#41; of the lower limbs&#46; The tests were done during the second week of their hospitalization &#40;12&#44;3&#8239;&#177;&#8239;3&#44;2 days&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We identified eleven patients with high D-Dimer value&#44; nine of them &#40;6&#44;7&#37;&#41; had signs of Pulmonary Artery Thrombosis &#40;PAT&#41; without Deep Venous Thrombosis &#40;DVT&#41;&#46; The lesions were distributed bilaterally at the lower arterial branches &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; None of the nine patients experienced an objective respiratory worsening and those in oxygen therapy &#40;5 patients&#41; maintained a constant flow&#46; Therapeutic anticoagulation was started with subcutaneous enoxaparin &#40;1&#8239;mg&#47;kg&#41; twice daily&#44; followed by warfarin&#46; All patients were discharged home&#58; length of hospital stay &#40;LOS&#41; 21&#44;1&#8239;&#177;&#8239;3&#44;7 days&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">In <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> the laboratory parameters were compared between patients with and without PAT&#58; five days after admission&#44; only D-Dimer value and lymphocyte count were significatively different between the two groups&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Parameters are expressed as mean &#177; SD and statistically evaluated by Student T test&#46; P&#8239;&#60;&#8239;0&#44;05 was considered statistically significant&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Coagulopathic disorders are significantly increased in COVID-19 patients&#44; especially among those with severe disease&#46; Several mechanisms combine systemic inflammation with alterations of coagulation in COVID 19 patients&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In severe or critically ill patients&#44; the endothelial cells are damaged and release a large amount of inflammatory mediators that may predispose vascular thrombosis&#46; A study performed in ICU setting reported an increased risk of Pulmonary Embolism &#40;PE&#41; in COVID-19 patients treated with Low Molecular Weight Heparin &#40;LMWH&#41; prophylaxis compared to the historical COVID 19 negative control group&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Another Study reported that the prevalence of Venous Thromboembolism Events &#40;VTE&#41; was higher in ICU compared to general wards patients&#58; 47&#37; vs 3&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">High blood values of the procoagulant factor levels including fibrinogen and D-dimers have been associated with the worst prognosis and higher mortality&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Kaminetzky and coworkers compared the results of a cohort of 62 patients who underwent CTPA for suspected PE prior to the first case of COVID 19&#44; with 62 patients COVID 19 positive&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> CTPA was positive for PE in 37&#37; of COVID 19 patients &#40;14&#44;5&#37; in pre COVID patients&#41;&#44; D-Dimer was associated with a higher prevalence of thromboembolic events and correlated with the degree of PE severity&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In a group of patients admitted to non-ICU wards&#44; DU failed to detect DVT independently of the severity of their condition and length of in-hospital bed rest&#46; The Authors observed that this is apparently in contrast with the relatively frequent reports of PE in hospitalized COVID-19 patients It is possible that local thrombi in the lungs may be the cause of pulmonary arterial manifestations&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44; 11</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In this paper we reported COVID-19 patients with interstitial pneumonia admitted in our non-ICU Ward&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">During the course of hospitalization&#44; in eleven of them&#44; we observed a progressive increase of D-Dimer over three times the normal value&#44; associated with low or normal values of other coagulation or inflammatory blood parameters &#40;CRP&#44; LDH&#44; Ferritin&#44; fibrinogen&#44; INR&#44; aPTT&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Nine CTPA demonstrated a distal thrombosis of the lower pulmonary arterial branches&#46; The mainly basal localization where the pulmonary inflammation is most diffuse and the loss of signs of DVT may suggest a pulmonary thrombosis rather than an embolism&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">It is noteworthy that no patients had any signs of respiratory worsening and some of them did not receive oxygen therapy and they were breathing room air&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; we described patients with moderate disease who developed a pulmonary vascular injury strictly correlated with an elevation of D-Dimer values&#46; This parameter may help clinicians in identifying COVID-19 stable patients at risk of concurrent pulmonary artery thrombosis&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Further studies will need to better define the meaning of these preliminary observations&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 527
            "Ancho" => 1505
            "Tamanyo" => 123044
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed Tomography Pulmonary Angiography &#40;CTPA&#41; described signs of Pulmonary Artery Thrombosis &#40;PAT&#41; involved the lower pulmonary branches &#40;yellow arrows&#41;&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All Pts admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PAT pts admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All pts 5 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PAT pts 5 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All Pts 10 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PAT pts 10 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C-Reactive Proteine &#40;mg&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;6&#8239;&#177;&#8239;58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;6&#8239;&#177;&#8239;58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;9 &#177; 65&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;6&#8239;&#177;&#8239;58&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;0 &#177; 25&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;5&#8239;&#177;&#8239; 27&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lymphocite &#40;mmc&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1294&#8239;&#177;&#8239;761&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1260 &#177; 414&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1465 &#177; 657&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1075 &#177; 219&#44;2<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1762 &#177; 858&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1290 &#177; 336&#44;7<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Platelets &#40;mmc&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">250&#44;000&#8239;&#177;&#8239;84&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">263&#44;000 &#177; 147&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">300&#44;000 &#177; 114&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">252&#44;800 &#177; 52&#44;900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">352&#44;300 &#177; 102&#44;900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">289&#44;000 &#177; 113&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fibrinogen &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">432&#44;3&#8239;&#177;&#8239;114&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">530 &#177; 121&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">428&#44;5 &#177; 138&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">426&#44;0 &#177; 14&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">379&#44;6 &#177; 100&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">466&#44;1 &#177; 142&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDH &#40;U&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">264&#44;4&#8239;&#177;&#8239;101&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">326&#44;2 &#177; 121&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">295&#44;2 &#177; 120&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">314&#44;5 &#177; 37&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">264&#44;0 &#177; 73&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">309 &#177; 63&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">INR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1 &#177; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#177; 0&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;05 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1 &#177; 0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D-Dimer Ug&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">465&#44;1&#8239;&#177;&#8239;121&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">627&#44;4 &#177; 178&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">538&#44;3 &#177; 102&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2143&#44;6 &#177; 327&#44;5<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">576&#44;9 &#177; 169&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1764&#44;9 &#177; 227&#44;5<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2586803.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">P&#8239;&#60;&#8239;0&#44;05&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Laboratory parameters in patients with Pulmonary Artery Thrombosis &#40;PAT&#41; and the patients without PAT&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus&#8211;infected pneumonia in Wuhan&#44; China"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Wang"
                            1 => "B&#46; Hu"
                            2 => "C&#46; Hu"
                            3 => "Z&#46; Fangfang"
                            4 => "L&#46; Xing"
                            5 => "Z&#46; Jing"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2020.1585"
                      "Revista" => array:7 [
                        "tituloSerie" => "JAMA&#46;"
                        "fecha" => "2020"
                        "volumen" => "323"
                        "numero" => "11"
                        "paginaInicial" => "1061"
                        "paginaFinal" => "1069"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32031570"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thromboinflammation and the hypercoagulability of COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;M&#46; Connors"
                            1 => "J&#46;H&#46; Levy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jth.14849"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Thromb Haemost&#46;"
                        "fecha" => "2020"
                        "volumen" => "18"
                        "numero" => "7"
                        "paginaInicial" => "1559"
                        "paginaFinal" => "1561"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32302453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ematological findings and complications of COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Terpos"
                            1 => "I&#46; Ntanasis-Stathopoulos"
                            2 => "I&#46; Elalamy"
                            3 => "E&#46; Kastritis"
                            4 => "T&#46;N&#46; Sergentanis"
                            5 => "M&#46; Politou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ajh.25829"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Ematol&#46;"
                        "fecha" => "2020"
                        "volumen" => "95"
                        "numero" => "7"
                        "paginaInicial" => "834"
                        "paginaFinal" => "847"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46; Tang"
                            1 => "H&#46; Bai"
                            2 => "X&#46; Chen"
                            3 => "J&#46; Gong"
                            4 => "D&#46; Li"
                            5 => "Z&#46; Sun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jth.14817"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Thromb Haemost&#46;"
                        "fecha" => "2020"
                        "volumen" => "18"
                        "numero" => "5"
                        "paginaInicial" => "1094"
                        "paginaFinal" => "1099"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32220112"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathological findings of COVID-19 associated with acute respiratory distress syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46; Xu"
                            1 => "L&#46; Shi"
                            2 => "Y&#46; Wang"
                            3 => "J&#46; Zhang"
                            4 => "L&#46; Huang"
                            5 => "C&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2213-2600(20)30076-X"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Resp Med&#46;"
                        "fecha" => "2020"
                        "volumen" => "8"
                        "numero" => "4"
                        "paginaInicial" => "420"
                        "paginaFinal" => "422"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Lillicrap"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jth.14781"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Thromb Haemost&#46;"
                        "fecha" => "2020"
                        "volumen" => "18"
                        "numero" => "Apr &#40;4&#41;"
                        "paginaInicial" => "786"
                        "paginaFinal" => "787"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32212240"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary embolism in COVID-19 patients&#58; awareness of an increased prevalence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Poissy"
                            1 => "J&#46; Goutay"
                            2 => "M&#46; Morgan Caplan"
                            3 => "E&#46; Parmentier"
                            4 => "T&#46; Duburqc"
                            5 => "F&#46; Lassalle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.120.047430"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circulation&#46;"
                        "fecha" => "2020"
                        "volumen" => "142"
                        "paginaInicial" => "184"
                        "paginaFinal" => "186"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of venous thromboembolism in hospitalized patients with COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Middeldorp"
                            1 => "M&#46; Coppens"
                            2 => "T&#46;F&#46; Van Haaps"
                            3 => "M&#46; Foppen"
                            4 => "A&#46;P&#46; Vlaar"
                            5 => "M&#46; M&#252;ller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jth.14888"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Thromb Haemost&#46;"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary embolism on CTPA in COVID-19 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Kaminetzky"
                            1 => "W&#46; Moore"
                            2 => "K&#46; Fansiwala"
                            3 => "J&#46;S&#46; Babb"
                            4 => "D&#46; Kaminetky"
                            5 => "L&#46;I&#46; Horowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/ryct.2020200308"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiothoracic Imaging&#46;"
                        "fecha" => "2020"
                        "volumen" => "2"
                        "numero" => "4"
                        "paginaInicial" => "220"
                        "paginaFinal" => "229"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of thrombotic complications in critically ill ICU patients with COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;A&#46; Klok"
                            1 => "M&#46;J&#46;H&#46;A&#46; Kruip"
                            2 => "N&#46;J&#46;M&#46; van der Meer"
                            3 => "M&#46;S&#46; Arbous"
                            4 => "P&#46;J&#46; Gommers"
                            5 => "K&#46;M&#46; Kant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.thromres.2020.04.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thromb Res&#46;"
                        "fecha" => "2020"
                        "volumen" => "191"
                        "paginaInicial" => "145"
                        "paginaFinal" => "147"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32291094"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary embolism or pulmonary thrombosis in COVID-19&#63; Is the recommendation to use high-dose heparin for thromboprophylaxis justified&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Cattaneo"
                            1 => "E&#46;M&#46; Bertinato"
                            2 => "S&#46; Birocchi"
                            3 => "C&#46; Brizio"
                            4 => "D&#46; Malavolta"
                            5 => "M&#46; Manzoni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0040-1712097"
                      "Revista" => array:3 [
                        "tituloSerie" => "Thromb Haemost&#46;"
                        "fecha" => "2020"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9157595"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/25310437/0000002700000003/v1_202105020809/S2531043720301859/v1_202105020809/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "72880"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/25310437/0000002700000003/v1_202105020809/S2531043720301859/v1_202105020809/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043720301859?idApp=UINPBA00004E"
]
Article information
ISSN: 25310437
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 12 8 20
2024 October 46 36 82
2024 September 61 27 88
2024 August 82 32 114
2024 July 70 39 109
2024 June 62 33 95
2024 May 75 37 112
2024 April 88 33 121
2024 March 74 33 107
2024 February 43 33 76
2024 January 53 37 90
2023 December 34 27 61
2023 November 65 66 131
2023 October 58 40 98
2023 September 43 42 85
2023 August 46 16 62
2023 July 69 31 100
2023 June 67 15 82
2023 May 109 38 147
2023 April 57 20 77
2023 March 100 30 130
2023 February 68 47 115
2023 January 57 21 78
2022 December 103 34 137
2022 November 102 45 147
2022 October 117 46 163
2022 September 113 47 160
2022 August 138 46 184
2022 July 160 57 217
2022 June 155 55 210
2022 May 142 63 205
2022 April 63 37 100
2022 March 111 58 169
2022 February 118 62 180
2022 January 182 76 258
2021 December 111 59 170
2021 November 108 53 161
2021 October 99 71 170
2021 September 122 50 172
2021 August 139 66 205
2021 July 151 54 205
2021 June 289 95 384
2021 May 659 134 793
2021 April 365 185 550
2021 March 173 67 240
2021 February 145 53 198
2021 January 203 53 256
2020 December 214 47 261
2020 November 105 42 147
2020 October 88 35 123
2020 September 229 92 321
2020 August 20 10 30
Show all

Follow this link to access the full text of the article

Pulmonology

Are you a health professional able to prescribe or dispense drugs?