Department of Angiology, University Hospital Zurich, Zurich, Switzerland.
Epidemiological Department, Azienda Zero, Veneto Region, Padua, Italy.
Thromb Res. 2022 Apr;212:44-50. doi: 10.1016/j.thromres.2022.02.008. Epub 2022 Feb 20.
Pulmonary embolism is a known complication of coronavirus disease 2019 (COVID-19). Epidemiological population data focusing on pulmonary embolism-related mortality is limited.
Veneto is a region in Northern Italy counting 4,879,133 inhabitants in 2020. All ICD-10 codes from death certificates (1st January 2018 to 31st December 2020) were examined. Comparisons were made between 2020 (COVID-19 outbreak) and the average of the two-year period 2018-2019. All-cause, COVID-19-related and the following cardiovascular deaths have been studied: pulmonary embolism, hypertensive disease, ischemic heart disease, atrial fibrillation/flutter, and cerebrovascular diseases.
In 2020, a total of 56,412 deaths were recorded, corresponding to a 16% (n = 7806) increase compared to the period 2018-2019. The relative percentage increase during the so-called first and second waves was 19% and 44%, respectively. Of 7806 excess deaths, COVID-19 codes were reported in 90% of death certificates. The percentage increase in pulmonary embolism-related deaths was 27% (95%CI 19-35%), 1018 deaths during the year 2020, compared to 804 mean annual deaths in the period 2018-2019. This was more evident among men, who experience an absolute increase of 147 deaths (+45%), than in women (+67 deaths; +14%). The increase was primarily driven by deaths recorded during the second wave (+91% in October-December). An excess of deaths, particularly among men and during the second wave, was also observed for other cardiovascular diseases, notably hypertensive disease, atrial fibrillation, cerebrovascular disease, and ischemic heart disease.
We observed a considerable increase of all-cause mortality during the year 2020. This was mainly driven by COVID-19 and its complications. The relative increase in the number of pulmonary embolism-related deaths was more prominent during the second wave, suggesting a possible underdiagnosis during the first wave.
肺栓塞是 2019 年冠状病毒病（COVID-19）的已知并发症。针对与肺栓塞相关死亡率的流行病学人群数据有限。
威尼托大区是意大利北部的一个地区，2020 年人口为 4879133 人。对死亡证明中的所有 ICD-10 编码（2018 年 1 月 1 日至 2020 年 12 月 31 日）进行了检查。对 2020 年（COVID-19 爆发）与 2018-2019 两年平均水平进行了比较。研究了全因、COVID-19 相关和以下心血管死亡：肺栓塞、高血压病、缺血性心脏病、心房颤动/扑动和脑血管疾病。
2020 年共记录了 56412 例死亡，与 2018-2019 年同期相比增加了 16%（n=7806）。所谓的第一波和第二波的相对百分比增加分别为 19%和 44%。在 7806 例超额死亡中，90%的死亡证明报告了 COVID-19 编码。肺栓塞相关死亡人数增加了 27%（95%CI 19-35%），即 2020 年有 1018 人死亡，而 2018-2019 年期间平均每年有 804 人死亡。在男性中，这一比例更为明显，绝对死亡人数增加了 147 人（增加 45%），而女性则增加了 67 人（增加 14%）。这种增加主要是由第二波期间记录的死亡（10 月至 12 月增加 91%）驱动的。在心血管疾病（尤其是高血压、心房颤动、脑血管疾病和缺血性心脏病）方面，男性和第二波期间的其他心血管疾病的死亡人数也出现了明显增加。
我们观察到 2020 年全因死亡率的大幅增加。这主要是由 COVID-19 及其并发症引起的。肺栓塞相关死亡人数的相对增加在第二波期间更为明显，这表明第一波期间可能存在漏诊。
