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Introduction
Following from the successful “RCEM weekly top five” series starting in April 2020, this is the fifth of a monthly format for EMJ readers. We have undertaken a focused search of the PubMed literature using a standardised COVID-19 search string. Our search between 1 February and 28 February 2020 returned 6712 papers limited to human subjects and English language. We also searched high-impact journals for papers of interest.
Our team have narrowed down the most interesting, relevant and important of the papers and provided a critical snapshot of five of those we felt most deserved EMJ reader attention. Importantly, we have highlighted the main findings from the papers with key limitations and considerations for EM clinicians when interpreting the work. In doing so, we have created an accessible window into pertinent research findings for our busy colleagues during this fast-paced and ever-changing COVID-19 landscape.
The papers are ranked in one of three categories, allowing you to focus on the papers that are most vital to your practice:
Worth a peek—interesting, but not yet ready for prime time
Head turner—new concepts
Game changer—this paper could/should change practice
This month’s searches were undertaken by the ED team in Coventry. Next month, we visit the historic naval city of Plymouth on the south coast and look forward to an armada of quality content.
Pulmonary embolism and deep vein thrombosis in COVID-19
Topic—Diagnosis
Rating—Head turner
This systematic review and meta-analysis of 27 studies containing 3342 patients with COVID-19 aimed to determine the incidence of pulmonary embolism (PE) and deep vein thrombosis (DVT) and to evaluate the diagnostic accuracy of D-dimers in this cohort. The pooled incidence of PE and DVT were 16.5% and 14.8%, respectively, with an increased incidence of PE in those admitted to intensive care (24.7%) compared with non-ICU patients (10.5%). These rates are markedly higher than previously reported incidences of PE in …
Footnotes
Twitter @leechcaroline, @DrEdHartley, @KJonesey78, @dsdarbyshire
Collaborators RCEM COVID-19 CPD Team: Dr Charles Reynard, Dr Anisa Jafar, Dr Govind Oliver, Dr Gabrielle Prager.
Contributors DD performed the literature search. CL assembled the team of authors. EH, MH and CL screened titles in the provided literature search and longlisted articles. CL hand-searched selected journals. All authors sifted the longlist and selected articles for inclusion. All authors contributed to writing and editing the final piece.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.