Pulmonary embolism in pneumonia

Abstract

Pneumonia and pulmonary embolism (PE) share common risk factors, radiological findings and one disease may induce the development of another. The clinical characteristics of pneumonia can completely mask the concomitant PE, which, along with the increase in D-dimer due to inflammatory events, significantly complicates the screening of patients who need imaging diagnostic methods. A specific feature (including the exact D-dimer cut-off value), which would clearly indicate concomitant PE in pneumonia has not yet been established. However, older age, comorbidities, chest pain, dyspnea and syncope are more common in pneumonia with coexisting PE than in pneumonia alone. In new coronavirus associated pneumonia (COVID-19), PE is far more frequent than in pneumonia caused by other microorganisms. PE in COVID-19 pneumonia is associated with risk factors such as male sex, higher levels of C-reactive protein and delayed hospitalization. Anticoagulant-prophylaxis reduces the incidence of PE in COVID-19 pneumonia.