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Fewer cases of pulmonary embolism diagnosed during COVID-19 pandemic

A study shows a significant decline in the number of cases of pulmonary embolism diagnosed in Vienna General Hospital during the COVID-19 pandemic
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(Vienna, 29 May 2020) A study led by Cihan Ay and Stephan Nopp from the Department of Medicine I found a decline in cases of pulmonary embolism diagnosed in Vienna General Hospital during the COVID-19 pandemic. The results show that there was a marked decline in the number of diagnosed cases and in the number of diagnostic procedures in the period between mid-March and the end of April 2020 compared to 2018 and 2019.

"Even at the start of the COVID-19 pandemic, many countries noticed a general decline in the number of patients presenting with acute conditions. Our study shows that this also applies to patients with pulmonary embolism in Vienna General Hospital,", reports principal investigator Cihan Ay.

For the purpose of the study, the number of diagnostic procedures for suspected pulmonary embolism and the incidence of new cases during the pandemic (calendar weeks 12 to 17) were compared with the figures for the same periods in 2018 and 2019. There was found to be a significant decline for both factors: incidence fell by 66% and the number of diagnostic procedures by 45%.

Fear of infection and reduced risk are possible reasons for the decline
"We can only speculate about the reasons behind this striking decline," emphasises Ay. "We know that there are a number of risk factors for pulmonary embolism, such as an operation or leg injury, for example. During lockdown, there has been a reduction in the number of operations performed, as well as in leisure activities that carry a risk of injury. At the same time, we have to assume that people with mild symptoms did not even go to hospital, for fear of being infected by coronavirus."

Symptoms that overlap with COVID-19
The study was funded by the "Medical-scientific fund of the Mayor of the federal capital Vienna" and is looks at what influence healthcare policy measures had on the diagnosis and incidence of new cases of disease. Another aspect is interesting in this respect: the overlap between symptoms of pulmonary embolism and those of COVID-19, especially where these include pulmonary infarction.

"Due to the similarity in the symptoms such as a cough, fever and shortness of breath it is also possible that affected patients were transferred to hospitals primarily treating COVID-19 patients and that this is a contributory factor in the marked decline in pulmonary embolism cases within Vienna General Hospital," reports Ay.

Studies in other hospitals would be required to confirm the results of this study.

Pulmonary embolism during the COVID-19 pandemic: decline in diagnostic procedures and incidence at a University Hospital. Res Pract Thromb Haemost. Nopp S, Janata-Schwatczek K, Prosch H, Shulym I, Königsbrügge O, Pabinger I, Ay C.