Possible associations between central venous pressure, D-Dimer, and pulmonary embolism severity index in COVID-19 acute respiratory distress syndrome patients

Mortality rate in COVID-19 is mainly contributed to respiratory failure caused by intractable acute respiratory distress syndrome (ARDS). However, the direct cause could be caused by diffusion failure or probably pulmonary embolism. Increased central venous pressure (CVP) will ensue in higher pulmonary vascular resistance and in turn would increase pulmonary arterial pressure. Coagulopathy is a common feature of severe acute respiratory syndrome coronavirus 2 infection, and an increase in D-dimer is the most common finding. These factors lead to thrombosis and finally embolism. We observed 14 intensive care unit-admitted COVID-19 patients suffered from CARDS from March to May 2020. We measured their CVP and D-dimer values and pulmonary embolism severity index (PESI) scores to search for possible associations. Only CVP and PESI scores were statistically significant between those three parameters (P < 0.005). Lack of regular D-dimer samples and measurements due to limited resources could be one of potential causes, which contributes to the insignificant value. Further investigations with larger samples should be advised.