Pulmonary Embolism &VTE in COVID-19

Venous thromboembolism (VTE) is the third most common cause of death among thrombosis-related conditions, and lead to over 500, 000 deaths in Europe every year. [1]

Most common causes of immortal from thrombosis related conditions:

1 - Ischaemic heart disease

2 - Ischaemic stroke

3 - VTE

Source: WikiDocs

Previous pulmonary embolism does not put a person at higher risk of COVID-19 infection [2]

But pulmonary embolism is a cause of clinical deterioration in viral pneumonia patients [2-4]

Patients with COVID-19 whether recovering at home or in hospital are at higher risk due to limited physical activity from being unwell and also social isolation restrictions. Therefore it is important to follow prophylactic measures to minimise the risk of VTE

General Advice from Thrombosis UK
Thrombosis and COVID-19, current information:

  1. Having blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism (PE), is not associated with an increased risk of acquiring COVID-19

  2. Anticoagulants themselves don't place patients at risk for COVID-19. What can be important are underlying disorders. For example, if anticoagulants are given to someone with a blood clot associated with active cancer; then the cancer and its treatment may result in immunosuppression, which places patients at risk. It's important to talk to your doctor about your individual situation if you are concerned

  3. D-dimer is a non-specific marker of inflammation or infection so it is not surprising that the levels will be high in those with the most severe Covid-19 infection. In some of the articles in the lay press, elevated D-dimer levels have been interpreted as indicating blood clots. This is an incorrect interpretation. Although D-dimer levels are elevated in most patients with blood clots, D-dimer levels also are elevated in many other disorders including infection. Therefore, an elevated D-dimer level in patients with COVID-19 infection alone is not evidence that they have a clot.

References:

1. Nazzareno Galié, Alessandra Manes, Fabio Dardi, Massimiliano Palazzini, Thrombolysis in high-risk patients with acute pulmonary embolism: underuse of a life-saving treatment in the real-world setting, European Heart Journal, Volume 41, Issue 4, 21 January 2020, Pages 530–533, https://doi.org/10.1093/eurheartj/ehz296

2. Throbosis UK: Blood clots (thrombosis) and Covid-19, Published 20 March 2020 https://thrombosisuk.org/news/post.php?s=2020-03-20-blood-clots-thrombosis-and-covid-19

3. Images in Cardiothoracic Imaging: COVID-19 Complicated by Acute Pulmonary Embolism https://doi.org/10.1148/ryct.2020200067

4. Gian Battista Danzi, Marco Loffi, Gianluca Galeazzi, Elisa Gherbesi, Acute pulmonary embolism and COVID-19 pneumonia: a random association?, European Heart Journal, , ehaa254, https://doi.org/10.1093/eurheartj/ehaa254

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