Desai Rupak, Gandhi Zainab, Singh Sandeep, Sachdeva Sonali, Manaktala Pritika, Savani Sejal, Desai Virmitra, Sachdeva Rajesh, Kumar Gautam
Division of Cardiology, Atlanta VA Medical Center, Decatur, GA 30033 USA.
Department of Internal Medicine, Geisinger Community Medical Center, Scranton, PA USA.
SN Compr Clin Med. 2020;2(12):2722-2725. doi: 10.1007/s42399-020-00605-5. Epub 2020 Oct 28.
There remains a high risk of thrombosis in patients affected by the SARS-CoV-2 virus and recent reports have shown pulmonary embolism (PE) as a cause of sudden death in these patients. However, the pooled rate of this deadly and frequently underdiagnosed condition among COVID-19 patients remains largely unknown. Given the frequency with which pulmonary embolism has been reported as a fatal complication of severe coronavirus disease, we sought to ascertain the actual prevalence of this event in COVID-19 patients. Using PubMed/Medline, EMBASE, and SCOPUS, a thorough literature search was performed to identify the studies reporting rate of PE among COVID-19. Random effects models were obtained to perform a meta-analysis, and statistics were used to measure inter-study heterogeneity. Among 3066 COVID-19 patients included from 9 studies, the pooled prevalence of PE was 15.8% (95% CI (6.0-28.8%), = 98%). The pooled rate in younger cohort (age < 65 years) showed a higher prevalence of 20.5% (95% CI (17.6-24.8%)) as compared to studies including relatively older cohort (age > 65 years) showing 14.3% (95% CI (2.9-30.1%)) ( < 0.05). Single-center studies showed a prevalence of 12.9% (95% CI 1.0-30.2%), while that of multicenter studies was 19.5% (95% CI 14.9-25.2%) ( < 0.05). Pulmonary embolism is a common complication of severe coronavirus disease and a high degree of clinical suspicion for its diagnosis should be maintained in critically ill patients.
感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒的患者仍然存在较高的血栓形成风险，最近的报告显示肺栓塞（PE）是这些患者猝死的一个原因。然而，这种致命且经常漏诊的疾病在2019冠状病毒病（COVID-19）患者中的合并发生率仍然很大程度上未知。鉴于肺栓塞作为严重冠状病毒病致命并发症的报告频率，我们试图确定这一事件在COVID-19患者中的实际患病率。利用PubMed/Medline、EMBASE和SCOPUS进行了全面的文献检索，以确定报告COVID-19患者中PE发生率的研究。获得随机效应模型以进行荟萃分析，并使用统计方法测量研究间的异质性。在纳入的9项研究中的3066例COVID-19患者中，PE的合并患病率为15.8%（95%置信区间（6.0 - 28.8%），I² = 98%）。与纳入年龄相对较大队列（年龄>65岁）的研究相比，年龄较小队列（年龄<65岁）的合并发生率显示出较高的患病率，为20.5%（95%置信区间（17.6 - 24.8%）），而年龄较大队列的患病率为14.3%（95%置信区间（2.9 - 30.1%））（P<0.05）。单中心研究显示患病率为12.9%（95%置信区间1.0 - 30.2%），而多中心研究的患病率为19.5%（95%置信区间14.9 - 25.2%）（P<0.05）。肺栓塞是严重冠状病毒病的常见并发症，对于重症患者应保持高度的临床怀疑以进行诊断。
