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Background Coronavirus disease 2019 (COVID-19) is characterised by dyspnoea and abnormal coagulation parameters, including raised D-dimer. Data suggests a high incidence of pulmonary embolism (PE) in ventilated patients with COVID-19. Objectives To determine the incidence of PE in hospitalised patients with COVID-19 and the diagnostic yield of Computer Tomography Pulmonary Angiography (CTPA) for PE. We also examined the utility of D-dimer and conventional pre-test probability for diagnosis of PE in COVID-19. Patients/methods Retrospective review of single-centre data of all CTPA studies in patients with suspected or confirmed COVID-19 identified from Electronic Patient Records (EPR). Results There were 1477 patients admitted with COVID-19 and 214 CTPA scans performed, of which n = 180 (84%) were requested outside of critical care. The diagnostic yield for PE was 37%. The overall proportion of PE in patients with COVID-19 was 5.4%. The proportions with Wells score of ≥4 (‘PE likely’) was 33/134 (25%) without PE vs 20/80 (25%) with PE (P = 0.951). The median National Early Warning-2 (NEWS2) score (illness severity) was 5 (interquartile range [IQR] 3–9) in PE group vs 4 (IQR 2–7) in those without PE (P = 0.133). D-dimer was higher in PE (median 8000 ng/mL; IQR 4665–8000 ng/mL) than non-PE (2060 ng/mL, IQR 1210–4410 ng/mL, P, Highlights • COVID-19 is associated with a higher rate of PE, particularly in critically-ill patients • Identifying those requiring PE imaging is challenging due to overlapping clinical presentation and high D-dimer in COVID-19 • Single-centre study of imaging outcomes (for PE), in patients with suspected/confirmed COVID-19 • 37% of inpatients scanned had PE. D-dimer >4200 ng/mL risk stratified, but could not exclude PE. • Clinicians should have high index of suspicion for PE in COVID-19

Purpose Patients hospitalized for infection with SARS-CoV-2 typically present with pneumonia. The respiratory failure is frequently complicated by pulmonary embolism in segmental pulmonary arteries. The distribution of pulmonary embolism in regard to lung parenchymal opacifications has not been investigated yet. Methods All patients with COVID-19 treated at a medical intensive care unit between March 8th and April 15th, 2020 undergoing computed tomography pulmonary angiography (CTPA) were included. All CTPA were assessed by two radiologists independently in respect to parenchymal changes and pulmonary embolism on a lung segment basis. Results Out of 22 patients with severe COVID-19 treated within the observed time period, 16 (age 60.4 ± 10.2 years, 6 female SAPS2 score 49.2 ± 13.9) underwent CT. A total of 288 lung segment were analyzed. Thrombi were detectable in 9/16 (56.3%) patients, with 4.4 ± 2.9 segments occluded per patient and 40/288 (13.9%) segments affected in the whole cohort. Patients with thrombi had significantly worse segmental opacifications in CT (p, Highlights (mandatory) • In COVID-19 respiratory failure, thrombi in segmental pulmonary arteries are common. • All Thrombi detected were localized in opacitated (presumably COVID-19 affected) lung segments. • This might suggest local clot formation.

Thromboembolic complications have emerged as a major hazard of the nephrotic syndrome. Thrombosis in both the arterial and venous sides of circulation has been reported. We report a case of a 22-year-old man who suffered pulmonary embolism involving the entire left lung and right ventrobasal segment.

A case is presented of a large interventricular septal defect, patent foramen ovale, pulmonary artery aneurysms, pulmonary artery thrombosis, with both direct pulmonary and indirect “paradoxical” systemic embolization.

1)A resume of the medical literature pertaining to the subject of thrombosis of the pulmonary artery and its right and left branches has been presented. 2)Pathologic changes associated with the condition have been discussed. 3)A definite clinical syndrome produced by such a thrombus has been described. 4)A typical case report, illustrating the syndrome, and substantiated by pathological material, was made.

The presence of unrecognized partial anomalous pulmonary venous connection may cause complications of pulmonary infarction and right-to-left shunting in patients undergoing the modified Fontan procedure. These complications can be prevented by identification of any anomalous pulmonary venous connection at preoperative cardiac catheterization.