Time	Events
Prior to admission	Two years before, the patient had developed low-risk pulmonary embolism (PE) following an orthopaedic elective surgery. He had started oral anticoagulation, discontinued after 6 months from the index event
Admission	The patient presented to the emergency department with a 10-day history of fatigue, fever, and dry cough Chest computed tomography revealed bilateral interstitial densities consistent with coronavirus disease 2019 Continuous positive airway pressure was started with clinical benefit, but few hours later he developed haemodynamic instability and deoxygenation Bedside transthoracic echocardiography revealed high-risk PE, with evidence of right ventricle dysfunction and a free-floating thrombus in right heart chambers Systemic thrombolysis was administered with excellent clinical and haemodynamic response
Follow-up	The patient was haemodynamically stable during his 5 days stay in the intensive care unit. After invasive ventilation weaning, the patient was transferred to the sub-intensive unit to complete the in-hospital course. No bleeding complication related to fibrinolysis occurred