Impact of Alteplase on Mortality in Critically Ill Patients with COVID-19 and Pulmonary Embolism

COVID-19 is an independent risk factor for pulmonary embolism (PE). Little known about alteplase therapy in this patient group. A retrospective study analyzed 74 patients with PE and acute respiratory distress syndrome (ARDS) due to who were hospitalized the intensive care unit 2021. Patients or without confirmed right heart thrombi (RHT) treated unfractionated heparin alteplase. The mortality rate RHT was 100% compared 37.9% 55.2% those RHT, respectively. of death group increased delayed thrombolysis (p = 0.009, odds ratio (OR) 1.73 95% CI (confidence interval) 1.14–2.62), D-dimer concentration 0.02, OR 1.43 1.06–1.93), decreased PaO2/FiO2 0.001, 0.56 0.41–0.78). receiver operating characteristic method determined that a 1-day delay thrombolytic treatment, >5.844 mg/L, <144 mmHg predicted fatal outcome. severe ARDS increases higher levels, PaO2/FiO2, treatment. Thrombolysis seems be treatment choice RHT. It should carried out as soon possible after diagnosis established.