key: cord-0773612-gec4t9z5
authors: Freund, Yonathan; Drogrey, Marie; Cachanado, Marine; Bloom, Ben
title: Re: Prevalence of Pulmonary Embolism in ED patients with Suspected COVID‐19: The Truth Remains Unknown
date: 2020-09-23
journal: Acad Emerg Med
DOI: 10.1111/acem.14138
sha: ab304321d5e67a9309c027a729883ac02aa866f9
doc_id: 773612
cord_uid: gec4t9z5

We thank « John Doe » et al. for their interest and comments on our paper “Association between Pulmonary Embolism and COVID‐19 in ED patients: the PEPCOV international retrospective study”. The authors raised the important issue of a possible bias, because we only analyzed patients that were tested for pulmonary embolism (PE) with computed tomography pulmonary angiogram (CTPA). We acknowledge that this is a limitation, and accordingly highlighted in our manuscript that whether these results apply to the general population is unknown.

We thank « John Doe » et al. for their interest and comments on our paper "Association between Pulmonary Embolism and COVID-19 in ED patients: the PEPCOV international retrospective study". 1, 2 The authors raised the important issue of a possible bias, because we only analyzed patients that were tested for pulmonary embolism (PE) with computed tomography pulmonary angiogram (CTPA). We acknowledge that this is a limitation, and accordingly highlighted in our manuscript that whether these results apply to the general population is unknown. We believe that adding exhaustive data on patient volume or characteristic of the "non-tested" group would be dangerously misleading: the characteristic and volume of patients that visited the ED during the pandemic period are very peculiar, as has been widely described, and would not have helped us to evaluate the magnitude of this bias.

Secondly, an issue was raised on whether the study week may have been a significant confounder. As reported in our manuscript, when adding the variable "week of study" in the model, there was no significant effect, neither in univariate analysis nor in bivariate As we acknowledged in our manuscript, we cannot exclude a biased estimate of PE prevalence in our study due to increased awareness of COVID-19 associated coagulopathy. However, we believe that this bias is of limited magnitude because the analysis limited to the pandemic period, and adjusted for the study week, confirmed our results. Furthermore, patients were included in our study until April 10 th , which was at a time up to which there were few reports of such coagulopathy.

Prevalence of Pulmonary Embolism in ED patients with Suspected COVID-19: The Truth Remains Unknown

Association Between Pulmonary Embolism and COVID-19 in Emergency Department Patients Undergoing Computed Tomography Pulmonary Angiogram: The PEPCOV International Retrospective Study

Accepted Article