Diagnosis and Treatment of Pulmonary Embolism During the Coronavirus Disease 2019 Pandemic: A Position Paper From the National PERT Consortium

Chest. 2020 Dec;158(6):2590-2601. doi: 10.1016/j.chest.2020.08.2064. Epub 2020 Aug 27.


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; PERT; catheter-directed thrombolysis; follow-up; prevention; pulmonary embolism; pulmonary embolism response team; systemic thrombolysis.

Publication types

  • Consensus Development Conference
  • Review

MeSH terms

  • Aftercare*
  • Ambulatory Care
  • Anticoagulants / therapeutic use*
  • COVID-19 / complications*
  • COVID-19 / metabolism
  • Computed Tomography Angiography
  • Echocardiography
  • Extracorporeal Membrane Oxygenation*
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Hospitalization*
  • Humans
  • Lower Extremity
  • Patient Care Team / organization & administration*
  • Point-of-Care Systems
  • Practice Guidelines as Topic
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / metabolism
  • Pulmonary Embolism / therapy*
  • Referral and Consultation
  • Risk Assessment
  • Thrombolytic Therapy / methods*
  • Ultrasonography


  • Anticoagulants
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D