ABSTRACT
Background: Pulmonary embolism (PE) have a high prevalence in COVID-19 patients. Best medical therapy and follow-up of these patients are still undefined. Methods: We conducted a retrospective single centre study in Alto Vicentino Hospital between March 1st, 2020, and January 31st, 2021 in 267 patients admitted for COVID-19 who underwent to computed tomography pulmonary angiogram (CTPA) for suspected PE. In 48 of them PE was diagnosed (18.7%). We followed these patients to look for deaths, recurrent thromboembolic events or relevant clinical hemorrhages. Type and duration of anticoagulation were analyzed. Results: The median follow-up was 13 months (IQR 1-14) and 4 patients were lost to follow-up. 16 patients died (36.4%), 1 patient had a new thromboembolic event (2.3%) and 3 had relevant hemorrhagic events (6.8%). 26 were treated with direct oral anticoagulants (DOAC) (59%), 2 with warfarin (4.5%) and 15 with heparin (34%). Median duration of anticoagulation was 5.8 months (CI 95% 4.08-7.54). Patients treated with DOAC presented a lower mortality then patients treated with heparin (3.8% vs 83.3%;p<0.001). Conclusions: PE in COVID-19 patients seems to be related to a relevant increased risk of death. Long term anticoagulation with DOAC in patients discharge at home appears to be safe and effective.