From the Guidelines

If you are experiencing shortness of breath after a COVID-19 pulmonary embolism (PE), it is essential to seek immediate medical attention.

Anticoagulation therapy: Continue anticoagulation therapy as prescribed, which may include medications such as apixaban (5mg twice daily) or rivaroxaban (15mg twice daily for 21 days, then 20mg once daily) 1.
Oxygen saturation monitoring: Monitor oxygen saturation levels and use supplemental oxygen as needed to maintain saturation above 92% 1.
Follow-up testing: Consider a follow-up chest CT scan or pulmonary function tests to assess lung function and rule out any potential complications, such as pulmonary fibrosis or impaired diffusion capacity for carbon monoxide 1.
Underlying condition management: Manage any underlying conditions, such as hypertension or heart disease, with medications like beta blockers (e.g., metoprolol 25-50mg daily) or ACE inhibitors (e.g., lisinopril 2.5-5mg daily) 1.
Pulmonary rehabilitation: Participate in a supervised pulmonary rehabilitation program to improve lung function and overall health 1.
Breathlessness management: Utilize controlled breathing techniques, such as pursed-lip breathing, breathing exercises, and coordinated breathing training, to help manage breathlessness 1. It is crucial to work closely with your healthcare provider to develop a personalized treatment plan and adjust medications or therapies as needed to manage your symptoms and prevent further complications, including the potential use of systemically administered thrombolytics in patients with hypotension or signs of obstructive shock due to PE 1.

From the Research

Dyspnea is a common symptom in patients with pulmonary embolism (PE) after COVID-19 infection 2, 3, 4
Studies have shown that pulmonary embolism is a potential complication that may occur late in the course of COVID-19 cases, and it is more likely to develop in patients with higher New York Heart Association (NYHA) classes 3
The frequency of pulmonary embolism in patients with new or ongoing dyspnea after a COVID-19 infection is significant, with one study reporting a frequency of 23.8% 3
Post-COVID-19 condition with pulmonary embolism predominantly affects females, and common symptoms include breathlessness and chest pain 4
The pathophysiology of COVID-19-associated PE may differ from the conventional non-COVID-19-associated PE, with in situ pulmonary thrombosis being a relevant factor in patients with COVID-19 5

Patients with post-COVID-19 condition and pulmonary embolism often have underlying conditions such as cancer or diabetes, and symptoms can overlap, complicating diagnosis 4
The one-year follow-up of patients with post-COVID-19 condition and pulmonary embolism showed normal lab results and no active lung lesions, but the elevated risk of pulmonary embolism persists 4
Lower utility scores and increased anxiety highlight the need for targeted interventions and mental health support in patients with post-COVID-19 condition and pulmonary embolism 4

Pulmonary embolism is a manifestation of acute COVID-19 infection, and clinicians should have an increased suspicion for pulmonary embolism in patients presenting with worsening dyspnea and hypoxia who were recently admitted for acute COVID-19 pneumonia 2
Computed tomographic angiography of the chest is a useful diagnostic tool for confirming the presence of pulmonary embolism 2
The acute treatment of COVID-19-associated PE is substantially similar to the management of conventional non-COVID-19 PE 5