Department of Systems Medicine, Infectious Disease Clinic, Tor Vergata University, Via Montpellier, 1 - 00133 Rome, Italy.
Clinical and Research Department on Infectious Diseases, National Institute for Infectious Diseases "L. Spallanzani", Via Portuense, 292 - 00147 Rome, Italy.
Int J Infect Dis. 2022 Feb;115:93-100. doi: 10.1016/j.ijid.2021.11.038. Epub 2021 Nov 27.
During the COVID-19 pandemic, several studies described an increased chance of developing pulmonary embolism (PE). Several scores have been used to predict the occurrence of PE. This systematic review summarizes the literature on predicting rules for PE in hospitalized COVID-19 patients (HCPs).
PUBMED and EMBASE databases were searched to identify articles (1 January 2020-28 April 2021) presenting data pertaining to the use of a prediction rule to assess the risk for PE in adult HCPs. The investigated outcome was the diagnosis of PE. Studies presenting data using a single laboratory assay for PE prediction were excluded. Included studies were appraised for methodological quality using the Newcastle - Ottawa Quality Assessment Scale for Cohort Studies (NOS).
We obtained a refined pool of twelve studies for five scoring systems (Wells score, Geneva score, CHADS2/CHA2DS2VASc/M-CHA2DS2VASc, CHOD score, Padua Prediction Score), and 4,526 patients. Only one score was designed explicitly for HCPs. Three and nine included studies were prospective and retrospective cohort studies, respectively. Among the examined scores, the CHOD score seems promising for predictive ability.
New prediction rules, specifically developed and validated for estimating the risk of PE in HCP, differentiating ICU from non-ICU patients, and taking into account anticoagulation prophylaxis, comorbidities, and the time from COVID-19 diagnosis are needed.
在 COVID-19 大流行期间，有几项研究描述了肺栓塞（PE）发生几率增加。已经使用了几种评分来预测 PE 的发生。本系统综述总结了关于预测 COVID-19 住院患者（HCP）中 PE 的预测规则的文献。
检索 PUBMED 和 EMBASE 数据库，以确定（2020 年 1 月 1 日至 2021 年 4 月 28 日）发表的数据，涉及使用预测规则评估成年 HCP 中 PE 风险的文章。研究的结局是 PE 的诊断。排除仅使用单一实验室检测方法预测 PE 的研究。使用 Newcastle-Ottawa 队列研究质量评估量表（NOS）评估纳入研究的方法学质量。
我们获得了五个评分系统（Wells 评分、日内瓦评分、CHADS2/CHA2DS2VASc/M-CHA2DS2VASc、CHOD 评分、Padua 预测评分）的十二项研究和 4526 例患者的精炼数据。只有一个评分是专门为 HCP 设计的。三项和九项研究分别为前瞻性和回顾性队列研究。在检查的评分中，CHOD 评分似乎具有预测能力的潜力。
需要开发和验证新的预测规则，以专门估计 HCP 中 PE 的风险，区分 ICU 和非 ICU 患者，并考虑抗凝预防、合并症和 COVID-19 诊断后的时间。
