Delayed Diagnosis of Pulmonary Thromboembolism Due to Overfocus on COVID-19.

Harada, Yukinori; Shimizu, Taro

The coronavirus disease 2019 (COVID-19) pandemic has made it difficult for physicians to follow their usual diagnostic processes. We present the case of a 25-year-old man with adjustment disorder who developed dyspnoea. He was concerned about COVID-19, but his test result was negative. After excluding COVID-19, the physician concluded that his symptoms were related to his psychiatric condition. However, the patient was diagnosed with pulmonary thromboembolism by another physician. To avoid missing a diagnosis, physicians must practice zero-based thinking, regardless of COVID-19 concerns, and not be distracted from the patient's core problems. LEARNING POINTS During the COVID-19 pandemic, significant diagnostic errors can occur because physicians are so concerned about COVID-19 that they may ignore other diagnoses.To avoid missing a life-threatening condition during the COVID-19 pandemic, physicians must consider zero-based thinking, regardless of COVID-19 concerns, and not be distracted from the patient's core problems.Measuring vital signs after a short walk can be helpful for investigating suspected pulmonary thromboembolism.