• Lorenzo Monfardini, Mauro Morassi, Paolo Botti, Roberto Stellini, Luca Bettari, Stefania Pezzotti, Marco Alì, Cristian Giuseppe Monaco, Veronica Magni, Andrea Cozzi, Simone Schiaffino, and Claudio Bnà.
• Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, Brescia, Italy.
• Br J Radiol. 2020 Sep 1; 93 (1113): 20200407.

ObjectivesTo present a single-centre experience on CT pulmonary angiography (CTPA) for the assessment of hospitalised COVID-19 patients with moderate-to-high risk of pulmonary thromboembolism (PTE).MethodsWe analysed consecutive COVID-19 patients (RT-PCR confirmed) undergoing CTPA in March 2020 for PTE clinical suspicion. Clinical data were retrieved. Two experienced radiologists reviewed CTPAs to assess pulmonary parenchyma and vascular findings.ResultsAmong 34 patients who underwent CTPA, 26 had PTE (76%, 20 males, median age 61 years, interquartile range 54-70), 20/26 (77%) with comorbidities (mainly hypertension, 44%), and 8 (31%) subsequently dying. Eight PTE patients were under thromboprophylaxis with low-molecular-weight heparin, four PTE patients had lower-limbs deep vein thrombosis at ultrasound examination (performed in 33/34 patients). Bilateral PTE characterised 19/26 cases, with main branches involved in 10/26 cases. Twelve patients had a parenchymal involvement >75%, the predominant pneumonia pattern being consolidation in 10/26 patients, ground glass opacities in 9/26, crazy paving in 5/26, and both ground glass opacities and consolidation in 2/26.ConclusionCOVID-19 patients are prone to PTE.Advances In KnowledgePTE, potentially attributable to an underlying thrombophilic status, may be more frequent than expected in COVID-19 patients. Extension of prophylaxis and adaptation of diagnostic criteria should be considered.

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