The following is the summary of “Acute phase characteristics and long-term complications of pulmonary embolism in COVID-19 compared to non-COVID-19 cohort: a large single-centre study” published in the January 2023 issue of Pulmonary medicine by Moreno, et al.

The goals of this study are to determine if risk stratification techniques are valid in this population by comparing patients with and without COVID-19 and assess the severity of pulmonary embolism (PE) and long-term consequences between patients with and without COVID-19. Patients hospitalized with PE between January 1, 2016, and December 31, 2022, were included in this retrospective analysis. Patients with and without COVID were compared for their acute episode features, PE risk classification, outcomes, and long-term consequences.

The sample size was large enough to draw meaningful conclusions: 116 COVID patients (27.5% of the total) and 305 non-COVID patients (72.5% of the total). Patients with COVID-19 had a decreased rate of DVT and did not exhibit the classic risk indicators for the condition. Lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels were all significantly higher in COVID patients. There was reduced right ventricular dysfunction in COVID patients (7.7% vs. 17.7%; P=0.007), smaller PE (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental, and 13.2% vs. 7.9% subsegmental; P<0.001), and a higher sPESI score (1.66 vs. 1.11; P<0.001). 

Patients with COVID were more likely to require mechanical breathing (8.6% vs. 1.3%; P<0.001), although they were less likely to die while hospitalized (5.2% vs. 10.8%; P=0.074). The COVID cohort had a significantly decreased rate of long-term problems (P<0.001). Patients with COVID who had a severe PE as determined by a high sPESI and those who were classified as moderate or high risk were more likely to die while hospitalized. Both short- and long-term hospitalization-related deaths were reduced in COVID-19. Patients with COVID can benefit from the standard risk assessment methods for PE.