Diagnosis and Treatment of Pulmonary Embolism During the COVID-19 Pandemic: A Position Paper From the National PERT Consortium

Chest. 2020 Aug 27;S0012-3692(20)34287-2. doi: 10.1016/j.chest.2020.08.2064. Online ahead of print.

Abstract

The coexistence of coronavirus disease 2019 (COVID-19) and pulmonary embolism (PE), two life-threatening illnesses, in the same patient presents a unique challenge. Guidelines have delineated how best to diagnose and manage patients with PE. However, the unique aspects of COVID-19 confound both the diagnosis and treatment of PE, and therefore require modification of established algorithms. Important considerations include adjustment of diagnostic modalities, incorporation of the prothrombotic contribution of COVID-19, management of two critical cardiorespiratory illnesses in the same patient, and protecting patients and health-care workers while providing optimal care. The benefits of a team-based approach for decision-making and coordination of care, such as that offered by pulmonary embolism response teams (PERTs), have become more evident in this crisis. The importance of careful follow-up care also is underscored for patients with these two diseases with long-term effects. This position paper from the PERT Consortium specifically addresses issues related to the diagnosis and management of PE in patients with COVID-19.

Keywords: COVID-19; VTE; catheter-directed thrombolysis; follow-up; prevention; pulmonary embolism; pulmonary embolism response team; systemic thrombolysis.

Publication types

  • Review