How necessary it is to perform a ventilation scan in patients with a history of COVID-19 to rule out pulmonary thromboembolism?

Objectives: This study evaluated the necessity of a ventilation scan in patients suspected of PE with a history of COVID-19 infection.

Methods: This was a cross-sectional study of patients with PCR-confirmed COVID-19 and suspected PE at a tertiary care hospital in 2020. They underwent ventilation/perfusion (V/Q) scintigraphy using single-photon emission computed tomography/computed tomography (SPECT/CT) and CT scans with or without contrast. Two blinded nuclear medicine physicians interpreted the images for PE and COVID-19. Clinical and laboratory data were extracted and analyzed.

Results: 96 patients with suspected PE and COVID-19 infection. The study excluded eight patients who could not undergo ventilation scans and confirmed PE in five patients with multiple mismatched V/Q defects on SPECT/CT. The study ruled out PE in 83 patients who had either regular perfusion scans, perfusion defects with COVID-19 features, or matched V/Q defects. The study found that the prevalence of PE was 5.68%, and the necessity of ventilation scans was 28.40% in this population.

Conclusion: It was found that PE was present in 5.68% of the patients, and ventilation scans were needed for 28.40% of the patients to confirm or exclude it.