Acute pulmonary embolism in times of SARS-CoV-2: Diagnostic and therapeutic management

Cristhian E. Scatularo, Sanatorio de la Trinidad, Buenos Aires, Argentina
Juan Farina, Servicio de Cardiología, Clínica Olivos, Buenos Aires, Argentina
Ignacio M. Cigalini, Servicio de Cardiología Intervencionista y Tratamientos Endovasculares, Hospital Privado de Rosario, Rosario, Argentina
Gonzalo E. Pérez, Clínica Olivos, Buenos Aires, Argentina
Fernando S. Wyss-Quintana, Cardiosolutions, Ciudad de Guatemala, Guatemala
Clara I. Saldarriaga-Giraldo, Servicio de Cardiología, Clínica CardioVID, Universidad de Antioquia. Antioquia, Colombia
Adrian Baranchuk, Queen’s University, Kingston, Ontario, Canada

There is a clear association between novel coronavirus 2 infection and the diagnosis of venous thromboembolic disease, as a cosequence of the development of a systemic inflammatory response syndrome due to the activation of the coagulation cascade. It occurs in 90% of patients with severe forms of the infection, evidencing the presence of pulmonary endovascular micro and macro thrombosis. This suggests a possible clinical benefit of thromboprophylaxis according to the patient’s clinical risk. The suspicion of venous thromboembolic disease in the context of this pandemic represents a diagnostic challenge due to the co-existence of similarities between both conditions in several different aspects. It should be noted that the diagnosis of acute pulmonary embolism does not exclude the possibility of simultaneous viral infection. The evaluation of patients with suspected acute pulmonary embolism in the context of the pandemic should be optimized in order to implement a rapid diagnosis and treatment to reduce the associated morbidity and mortality. This will help reducing infectious risk for health-care professionals and other patients.

Keywords: Pulmonary embolism. Coronavirus infections. COVID-19. Thrombosis.