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

• Type of Material: Article
• Authors: Rachel P. Rosovsky, Harvard University; Charles Grodzin, Emory University; Richard Channick, University of California Los Angeles; George A. Davis, University of Kentucky; Jay s. Giri, University of Pennsylvania; James Horowitz, New York University; Christopher Kabrhel, Harvard University; Robert Lookstein, Mount Sinai Medical Center; Geno Merli, Thomas Jefferson University; Timothy A. Morris, University of California San Diego; Belinda Rivera-Lebron, University of Pittsburgh; Victor Tapson, Cedars Sinai Medical Center; Thomas M. Todoran, Medical University of South Carolina; Aaron S. Weinberg, Cedars Sinai Medical Center; Kenneth Rosenfield, Harvard Medical School
• Language: English
• Date: 2020-12-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.chest.2020.08.2064
• Title of Journal or Parent Work: Chest
• Volume: 158
• Issue: 6
• Start Page: 2590
• End Page: 2601
• Grant/Funding Information: None declared
• Keywords: follow-up; pulmonary embolism response team; Science & Technology; systemic thrombolysis; COVID-19; PERT; Respiratory System; Life Sciences & Biomedicine; Critical Care Medicine; Organizational surgery; General & Internal Medicine; prevention; Outpatient; catheter-directed thrombolysis; pulmonary embolism
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health; Health Sciences, Health Care Management

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.