{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T23:01:17Z","timestamp":1780268477778,"version":"3.54.0"},"reference-count":59,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"The Kaiser Permanente Northern California Community Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TH Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The diagnostic evaluation of pulmonary embolism (PE) in pregnancy is challenging, as the physiologic changes of pregnancy can mimic several PE symptoms. Acute respiratory infections introduce additional diagnostic complexity by producing systemic inflammation, altering vital signs, and, in some cases, elevating D-dimer levels. As a case in point, we examined how SARS-CoV-2 infection affected presentation, pretest probability, and diagnostic testing in pregnant patients with possible PE.<\/jats:p>\n                  <jats:p>We performed a retrospective cohort study across 21 community medical centers from October 1, 2021, to March 30, 2023. We included pregnant outpatients \u2265 18 years evaluated for suspected PE with D-dimer testing, compression ultrasonography, computed tomography pulmonary angiography (CTPA), or lung scintigraphy. We compared patients with and without COVID-19 using bivariate analysis.<\/jats:p>\n                  <jats:p>Among 860 patients, the median age was 30.0 years; 39.1% were in the third trimester. COVID-19 was present in 147 (17.1%). Compared with non-COVID-19 patients, those with COVID-19 more often had fever (36.1% vs. 4.2%), tachycardia \u2265 110\u2009bpm (66.0% vs. 34.2%), and oxygen saturation\u2009&lt;\u200995% (12.2% vs. 4.8%), but less often reported chest pain (49.7% vs. 65.5%; all p\u2009&lt;\u20090.001). Nearly all patients had low-to-intermediate pretest probability, but intermediate classification was more common with COVID-19 patients (63.3% vs. 39.0%; p\u2009&lt;\u20090.001). COVID-19 patients more often had elevated D-dimer\u2009&gt;\u20091.0\u2009mg\/L (49.1% vs. 36.4%; p\u2009&lt;\u20090.001) and more commonly underwent chest radiography (61.9% vs. 50.1%; p\u2009=\u20090.009). Among patients who underwent advanced imaging (n\u2009=\u2009393), CTPA predominated in both cohorts. Overall, PE was rare (n\u2009=\u20096; 0.7%), and mortality was low (n\u2009=\u20093; 0.3%).<\/jats:p>\n                  <jats:p>COVID-19 in pregnancy was associated with worse vital signs, higher pretest probability, higher D-dimer values, and increased diagnostic testing. These findings illustrate how acute respiratory infections may recalibrate PE risk assessment in pregnancy and highlight the need to refine diagnostic strategies when infection-related physiologic changes are present.<\/jats:p>","DOI":"10.1055\/a-2872-1408","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T23:14:31Z","timestamp":1778541271000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Antenatal Pulmonary Embolism Diagnostics in Pregnant Patients with SARS-CoV-2 Infection in Community Hospitals"],"prefix":"10.1055","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5277-6433","authenticated-orcid":false,"given":"Cole J.","family":"Florio","sequence":"additional","affiliation":[{"name":"California Northstate University College of Medicine, California, United States","place":["Elk Grove"]},{"name":"Kaiser Permanente CREST Network, California, United States","place":["Pleasanton"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1610-3314","authenticated-orcid":false,"given":"Grace V.","family":"Heringer","sequence":"additional","affiliation":[{"name":"Kaiser Permanente CREST Network, California, United States","place":["Pleasanton"]},{"name":"Sutter Davis Hospital, California, United States","place":["Davis"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4683-8661","authenticated-orcid":false,"given":"Madeline J.","family":"Somers","sequence":"additional","affiliation":[{"name":"Kaiser Permanente CREST Network, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Northern California, California, United States","place":["Pleasanton"],"department":["Division of Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Qiao","sequence":"additional","affiliation":[{"name":"California Northstate University College of Medicine, California, United States","place":["Elk Grove"]},{"name":"University of Rochester Medical Center, New York, United States","place":["Rochester"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Zekar","sequence":"additional","affiliation":[{"name":"UC Davis Health, California, United States","place":["Sacramento"],"department":["Department of Emergency Medicine"]},{"name":"US Acute Care Solutions, Carteret General Hospital, North Carolina, United States","place":["Morehead City"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cydney E.","family":"Middleton","sequence":"additional","affiliation":[{"name":"UC Davis Health, California, United States","place":["Sacramento"],"department":["Department of Emergency Medicine"]},{"name":"David Grant Medical Center, Travis Air Force Base, California, United States","department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara T.","family":"Woldemariam","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Oakland Medical Center, California, United States","place":["Oakland"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nachiketa","family":"Gupta","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group Inc, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Redwood City Medical Center, California, United States","place":["Redwood City"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke S.","family":"Poth","sequence":"additional","affiliation":[{"name":"Kaiser Permanente CREST Network, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Northern California, California, United States","place":["Pleasanton"],"department":["Division of Research"]},{"name":"The Permanente Medical Group Inc, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente South San Francisco Medical Center, California, United States","place":["South San Francisco"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8203-1016","authenticated-orcid":false,"given":"Mary E.","family":"Reed","sequence":"additional","affiliation":[{"name":"Kaiser Permanente CREST Network, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Northern California, California, United States","place":["Pleasanton"],"department":["Division of Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4523-5009","authenticated-orcid":false,"given":"Jeffrey D.","family":"Sperling","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group Inc, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Modesto Medical Center, California, United States","place":["Modesto"],"department":["Department of Maternal-Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1063-6155","authenticated-orcid":false,"given":"Nareg H.","family":"Roubinian","sequence":"additional","affiliation":[{"name":"Kaiser Permanente CREST Network, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Northern California, California, United States","place":["Pleasanton"],"department":["Division of Research"]},{"name":"The Permanente Medical Group Inc, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Oakland Medical Center, California, United States","place":["Oakland"],"department":["Department of Pulmonary and Critical Care Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6559-1858","authenticated-orcid":false,"given":"David R.","family":"Vinson","sequence":"additional","affiliation":[{"name":"Kaiser Permanente CREST Network, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Northern California, California, United States","place":["Pleasanton"],"department":["Division of Research"]},{"name":"UC Davis Health, California, United States","place":["Sacramento"],"department":["Department of Emergency Medicine"]},{"name":"The Permanente Medical Group Inc, California, United States","place":["Pleasanton"]},{"name":"Kaiser Permanente Roseville Medical Center, California, United States","place":["Roseville"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ijgo.2015.06.054","article-title":"A systematic review and meta-analysis of the epidemiology and burden of venous thromboembolism among pregnant women","volume":"132","author":"G Kourlaba","year":"2016","journal-title":"Int J Gynaecol Obstet"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1001\/archinte.162.10.1170","article-title":"Suspected pulmonary embolism in pregnancy: clinical presentation, results of lung scanning, and subsequent maternal and pediatric outcomes","volume":"162","author":"W S Chan","year":"2002","journal-title":"Arch Intern Med"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1373\/clinchem.2004.044883","article-title":"D-dimer concentrations in normal pregnancy: new diagnostic thresholds are needed","volume":"51","author":"J A Kline","year":"2005","journal-title":"Clin Chem"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1590\/S1807-59322010000600006","article-title":"The association between plasma D-dimer levels and community-acquired pneumonia","volume":"65","author":"S Arslan","year":"2010","journal-title":"Clinics (Sao Paulo)"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1159\/000050529","article-title":"Diagnostic value of D dimer in pulmonary embolism and pneumonia","volume":"68","author":"D J Castro","year":"2001","journal-title":"Respiration"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"2817","DOI":"10.3390\/v14122817","article-title":"Thromboembolic events in patients with influenza: a scoping review","volume":"14","author":"R Rubino","year":"2022","journal-title":"Viruses"},{"issue":"07","key":"ref7","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1002\/ajh.25829","article-title":"Hematological findings and complications of COVID-19","volume":"95","author":"E Terpos","year":"2020","journal-title":"Am J Hematol"},{"issue":"09","key":"ref8","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1111\/aogs.13962","article-title":"A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19","volume":"99","author":"R D'Souza","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"09","key":"ref9","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1097\/CCM.0000000000004458","article-title":"Coagulopathy of coronavirus disease 2019","volume":"48","author":"T Iba","year":"2020","journal-title":"Crit Care Med"},{"issue":"11","key":"ref10","doi-asserted-by":"crossref","first-page":"3109","DOI":"10.1111\/jth.15029","article-title":"Hypoxia-an overlooked trigger for thrombosis in COVID-19 and other critically ill patients","volume":"18","author":"J Thachil","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1016\/j.mayocp.2021.07.002","article-title":"Thromboembolic risk in hospitalized and nonhospitalized COVID-19 patients: a self-controlled case series analysis of a nationwide cohort","volume":"96","author":"F K Ho","year":"2021","journal-title":"Mayo Clin Proc"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1001\/jamainternmed.2021.0488","article-title":"Incidence of 30-day venous thromboembolism in adults tested for SARS-CoV-2 infection in an integrated health care system in Northern California","volume":"181","author":"N H Roubinian","year":"2021","journal-title":"JAMA Intern Med"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1007\/s00404-025-08007-5","article-title":"SARS-CoV-2 infection in pregnant women and incidence of thromboembolic disease: an analysis of the COVID-19-related obstetric and neonatal outcome study (CRONOS) in Germany","volume":"311","author":"U Pecks","year":"2025","journal-title":"Arch Gynecol Obstet"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.thromres.2024.02.021","article-title":"Low absolute risk of thrombotic and cardiovascular events in outpatient pregnant women with COVID-19","volume":"237","author":"B Bikdeli","year":"2024","journal-title":"Thromb Res"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"2590","DOI":"10.1016\/j.chest.2020.08.2064","article-title":"Diagnosis and treatment of pulmonary embolism during the coronavirus disease 2019 pandemic: a position paper from the National PERT Consortium","volume":"158","author":"R P Rosovsky","year":"2020","journal-title":"Chest"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1016\/j.chest.2020.05.559","article-title":"Prevention, diagnosis, and treatment of VTE in patients with coronavirus disease 2019: CHEST guideline and expert panel report","volume":"158","author":"L K Moores","year":"2020","journal-title":"Chest"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1111\/acem.15045","article-title":"Consent to advanced imaging in antenatal pulmonary embolism diagnostics: Prevalence, outcomes of nonconsent and opportunities to mitigate delayed diagnosis risk","volume":"32","author":"D R Vinson","year":"2025","journal-title":"Acad Emerg Med"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"102695","DOI":"10.1016\/j.rpth.2025.102695","article-title":"Preemptive anticoagulation during antenatal pulmonary embolism diagnostics in a community setting: retrospective cohort study","volume":"9","author":"A R Campbell","year":"2025","journal-title":"Res Pract Thromb Haemost"},{"issue":"11","key":"ref19","doi-asserted-by":"crossref","first-page":"e2541255","DOI":"10.1001\/jamanetworkopen.2025.41255","article-title":"Strategies to reduce advanced imaging in antenatal pulmonary embolism diagnostics","volume":"8","author":"D R Vinson","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"12","key":"ref20","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1111\/acem.70153","article-title":"Advanced imaging in suspected antenatal pulmonary embolism in community practice: preferences, indeterminacy, and clinician response","volume":"32","author":"D R Vinson","year":"2025","journal-title":"Acad Emerg Med"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/acem.15082","article-title":"Balancing risks and priorities: achieving right care in diagnosing pulmonary embolism during pregnancy","volume":"32","author":"P M Roy","year":"2025","journal-title":"Acad Emerg Med"},{"issue":"11","key":"ref22","doi-asserted-by":"crossref","first-page":"e2541261","DOI":"10.1001\/jamanetworkopen.2025.41261","article-title":"Clinical evaluation of pulmonary embolism during pregnancy","volume":"8","author":"L M Westafer","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"87","DOI":"10.7812\/TPP\/22.172","article-title":"Comparing Kaiser Permanente members to the general population: implications for generalizability of research","volume":"27","author":"A C Davis","year":"2023","journal-title":"Perm J"},{"issue":"39","key":"ref24","doi-asserted-by":"crossref","first-page":"e30800","DOI":"10.1097\/MD.0000000000030800","article-title":"Perfusion-only imaging in pregnant women: a comparative reader study with implications for practice patterns","volume":"101","author":"J A Schroeder","year":"2022","journal-title":"Medicine (Baltimore)"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.chest.2017.08.005","article-title":"Performance of low-dose perfusion scintigraphy and CT pulmonary angiography for pulmonary embolism in pregnancy","volume":"153","author":"J J Sheen","year":"2018","journal-title":"Chest"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"630","DOI":"10.2967\/jnumed.120.245571","article-title":"Diagnostic evaluation of pulmonary embolism during the COVID-19 pandemic","volume":"61","author":"L S Zuckier","year":"2020","journal-title":"J Nucl Med"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"598","DOI":"10.2967\/jnumed.121.262580","article-title":"Experience with a perfusion-only screening protocol for evaluation of pulmonary embolism during the COVID-19 pandemic surge","volume":"63","author":"A Kumar","year":"2022","journal-title":"J Nucl Med"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4103\/atm.atm_42_23","article-title":"The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: a single-center study of 434 patients","volume":"18","author":"T B Cengiz","year":"2023","journal-title":"Ann Thorac Med"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"703","DOI":"10.5811\/westjem.2020.2.45028","article-title":"Presyncope is associated with intensive care unit admission in emergency department patients with acute pulmonary embolism","volume":"21","author":"D R Vinson","year":"2020","journal-title":"West J Emerg Med"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"637375","DOI":"10.3389\/fmed.2021.637375","article-title":"Diagnostic delay of pulmonary embolism in COVID-19 patients","volume":"8","author":"F Melazzini","year":"2021","journal-title":"Front Med (Lausanne)"},{"issue":"11","key":"ref31","doi-asserted-by":"crossref","first-page":"e1013365","DOI":"10.1371\/journal.ppat.1013365","article-title":"Genomic and epidemiologic characteristics of SARS-CoV-2 persistent infections in California, January 2021 - July 2023","volume":"21","author":"J M Bell","year":"2025","journal-title":"PLoS Pathog"},{"issue":"12","key":"ref32","doi-asserted-by":"crossref","first-page":"855","DOI":"10.7326\/M18-1206","article-title":"Increasing safe outpatient management of emergency department patients with pulmonary embolism: a controlled pragmatic trial","volume":"169","author":"D R Vinson","year":"2018","journal-title":"Ann Intern Med"},{"issue":"05","key":"ref33","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1093\/aje\/kwf068","article-title":"Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter?: the Public Health Disparities Geocoding Project","volume":"156","author":"N Krieger","year":"2002","journal-title":"Am J Epidemiol"},{"issue":"12","key":"ref34","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1056\/NEJMoa1813865","article-title":"Pregnancy-adapted YEARS algorithm for diagnosis of suspected pulmonary embolism","volume":"380","author":"L M van der Pol","year":"2019","journal-title":"N Engl J Med"},{"issue":"08","key":"ref35","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1111\/jth.14483","article-title":"Could the YEARS algorithm be used to exclude pulmonary embolism during pregnancy? Data from the CT-PE-pregnancy study","volume":"17","author":"E Langlois","year":"2019","journal-title":"J Thromb Haemost"},{"issue":"10","key":"ref36","doi-asserted-by":"crossref","first-page":"2454","DOI":"10.1111\/jth.15432","article-title":"D-dimer to rule out venous thromboembolism during pregnancy: a systematic review and meta-analysis","volume":"19","author":"M Bellesini","year":"2021","journal-title":"J Thromb Haemost"},{"issue":"03","key":"ref37","doi-asserted-by":"crossref","first-page":"1901647","DOI":"10.1183\/13993003.01647-2019","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): the Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)","volume":"54","author":"S V Konstantinides","year":"2019","journal-title":"Eur Respir J"},{"issue":"13","key":"ref39","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1016\/j.jacc.2025.11.005","article-title":"2026 AHA\/ACC\/ACCP\/ACEP\/CHEST\/SCAI\/SHM\/SIR\/SVM\/SVN guideline for the evaluation and management of acute pulmonary embolism in adults: a report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines","volume":"87","author":"M A Creager","year":"2026","journal-title":"J Am Coll Cardiol"},{"issue":"12","key":"ref40","doi-asserted-by":"crossref","first-page":"3044","DOI":"10.1111\/jth.15521","article-title":"Assessing the clinical probability of pulmonary embolism during pregnancy: the Pregnancy-Adapted Geneva (PAG) score","volume":"19","author":"H Robert-Ebadi","year":"2021","journal-title":"J Thromb Haemost"},{"issue":"03","key":"ref41","doi-asserted-by":"crossref","first-page":"104241","DOI":"10.1016\/j.lpm.2024.104241","article-title":"Diagnostic management of acute pulmonary embolism","volume":"53","author":"M V Huisman","year":"2024","journal-title":"Presse Med"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.ijid.2021.11.038","article-title":"Predictive scores for the diagnosis of pulmonary embolism in COVID-19: a systematic review","volume":"115","author":"L V Rindi","year":"2022","journal-title":"Int J Infect Dis"},{"issue":"01","key":"ref43","first-page":"40","article-title":"Utility of probability scores for the diagnosis of pulmonary embolism in patients with SARS-CoV-2 infection: a systematic review","volume":"223","author":"A I Franco-Moreno","year":"2023","journal-title":"Rev Clin Esp (Barc)"},{"issue":"08","key":"ref44","doi-asserted-by":"crossref","first-page":"5540","DOI":"10.1007\/s00330-023-09475-6","article-title":"Strategies to safely rule out pulmonary embolism in COVID-19 outpatients: a multicenter retrospective study","volume":"33","author":"G Chassagnon","year":"2023","journal-title":"Eur Radiol"},{"issue":"01","key":"ref45","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/joim.13646","article-title":"Effective prognostic and clinical risk stratification in COVID-19 using multimodality biomarkers","volume":"294","author":"A Liu","year":"2023","journal-title":"J Intern Med"},{"issue":"09","key":"ref46","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1177\/00031348221091940","article-title":"Correlation of D-dimer and outcomes in COVID-19 patients","volume":"88","author":"H M Nemec","year":"2022","journal-title":"Am Surg"},{"issue":"11","key":"ref47","doi-asserted-by":"crossref","first-page":"766","DOI":"10.7326\/M18-1670","article-title":"Diagnosis of pulmonary embolism during pregnancy: a multicenter prospective management outcome study","volume":"169","author":"M Righini","year":"2018","journal-title":"Ann Intern Med"},{"issue":"09","key":"ref48","doi-asserted-by":"crossref","first-page":"e007960","DOI":"10.1161\/CIRCEP.121.007960","article-title":"Sinus tachycardia: a multidisciplinary expert focused review","volume":"15","author":"K A Mayuga","year":"2022","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"04","key":"ref49","doi-asserted-by":"crossref","first-page":"e12538","DOI":"10.1002\/emp2.12538","article-title":"Clinical characteristics of COVID-19 patients evaluated in the emergency department: a retrospective cohort study of 801 cases","volume":"2","author":"D M Cotton","year":"2021","journal-title":"J Am Coll Emerg Physicians Open"},{"issue":"10","key":"ref50","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1164\/rccm.201108-1575ST","article-title":"An official American Thoracic Society\/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy","volume":"184","author":"A N Leung","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"issue":"02","key":"ref51","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1177\/14782715221103670","article-title":"Pneumonia and concealed pulmonary embolism: a case report and literature review","volume":"52","author":"M Sadeq Ahmed","year":"2022","journal-title":"J R Coll Physicians Edinb"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"1680758","DOI":"10.3389\/fcvm.2025.1680758","article-title":"Case report: a case of severe viral pneumonia complicated by pulmonary embolism treated with extracorporeal membrane oxygenation combined with interventional thrombectomy","volume":"12","author":"J Wang","year":"2025","journal-title":"Front Cardiovasc Med"},{"key":"ref53","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1186\/s12879-014-0665-2","article-title":"Respiratory syncytial virus infection-associated hospitalization in adults: a retrospective cohort study","volume":"14","author":"C Volling","year":"2014","journal-title":"BMC Infect Dis"},{"issue":"04","key":"ref54","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1097\/AOG.0b013e3181b8e76d","article-title":"Community-acquired pneumonia in pregnancy","volume":"114","author":"J S Sheffield","year":"2009","journal-title":"Obstet Gynecol"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.bpobgyn.2022.07.001","article-title":"Bacterial pneumonia infection in pregnancy","volume":"85","author":"T Ashby","year":"2022","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"03","key":"ref56","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.clp.2005.04.009","article-title":"Influenza and pneumonia in pregnancy","volume":"32","author":"V R Laibl","year":"2005","journal-title":"Clin Perinatol"},{"issue":"10","key":"ref57","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1016\/j.jtha.2023.05.023","article-title":"Accuracy of physicians' intuitive risk estimation in the diagnostic management of pulmonary embolism: an individual patient data meta-analysis","volume":"21","author":"R van Maanen","year":"2023","journal-title":"J Thromb Haemost"},{"issue":"05","key":"ref58","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/MEJ.0000000000000967","article-title":"Comparison of the safety and efficacy of YEARS, PEGeD, 4PEPS or the sole item \u201cPE is the most likely diagnosis\u201d strategies for the diagnosis of pulmonary embolism in the emergency department: post-hoc analysis of two European cohort studies","volume":"29","author":"M Roussel","year":"2022","journal-title":"Eur J Emerg Med"},{"issue":"05","key":"ref59","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.annemergmed.2022.09.014","article-title":"Comparison of YEARS and adjust-unlikely D-dimer testing for pulmonary embolism in the Emergency Department","volume":"81","author":"K de Wit","year":"2023","journal-title":"Ann Emerg Med"},{"issue":"01","key":"ref60","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S2213-2600(25)00292-9","article-title":"D-Dimer thresholds for diagnosis of pulmonary embolism based on a single question: is it the most likely diagnosis? A prospective, multicentre, open-label, single-arm interventional study","volume":"14","author":"M Roussel","year":"2026","journal-title":"Lancet Respir Med"}],"container-title":["TH Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2872-1408.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T22:31:15Z","timestamp":1780266675000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2872-1408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":59,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2026,1,9]]},"published-print":{"date-parts":[[2026]]}},"alternative-id":["a28721408"],"URL":"https:\/\/doi.org\/10.1055\/a-2872-1408","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2512-9465"],"issn-type":[{"value":"2512-9465","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5,11]]},"published":{"date-parts":[[2026,5,11]]}}}