Editorial - April 2021

Dear friends and colleagues,

We all hoped that COVID-19 pandemic will be over soon. Unfortunately, almost in the whole Europe we are still fighting SarsCoV-2. We are facing several restrictions, personal contacts are very limited. Therefore online contacts are so important. We would like to thank you for the participation and a vivid discussion during two webinars organized by our working group that took place in February and in March. Webinars were dedicated to the implementation into a daily clinical practice of ESC Guidelines on the diagnosis and treatment of acute pulmonary embolism (PE).

Watch the recordings:
Part 1: Acute phase - diagnosis and risk adjusted management
Part 2: challenges of managing PE in the long term

Among several topic diagnostic and therapeutic challenges in the acute phase of PE in COVID-19 patients, in my opinion, was very highly appreciated and discussed. We all are aware that COVID-19 infection on a major risk factor for venous thromboembolism (VTE), and VTE is reported in approx. 5-10% of patients hospitalized in a general department and exceeds 50% in patients treated in ICU. There in an ongoing debate on the optimal primary VTE prophylaxis. If standard prophylactic dose of LMWH is sufficient or higher doses should be preferred. Results of very recently published Randomized Clinical Trial INSPIRATION showed that standard prophylactic dose of LMWH is non inferior to half therapeutic dose for VTE prevention in severely ill COVID-19 patients.

In this edition of the newsletter, we highlight a recent paper entitled “Non-invasive early exclusion of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: the InShape II study”, Thorax 2021. Incomplete thrombus resolution occurs in 25-50% of patients after acute PE despite adequate anticoagulation may lead to chronic thromboembolic pulmonary hypertension (CTEPH). Unfortunately, there is an unacceptable diagnostic delay of CTPEH potentially affecting prognosis. That indicates not only the need of higher awareness of this disease but also suggests diagnostic algorithms easy to be uses in a daily clinical practice.

Please find comment of this article.

Stay strong and stay safe,

 
On behalf of the Working Group Nucleus,
Piotr Pruszczyk, 
Chairman of the Working Group