Department of Translational Medicine, Section of Internal and Cardio-Respiratory Medicine, University of Ferrara, Ferrara, Italy.
Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium.
Am J Cardiol. 2022 May 15;171:159-164. doi: 10.1016/j.amjcard.2022.01.051. Epub 2022 Mar 8.
To date, the actual prevalence of acute pulmonary embolism (PE) in patients with SARS-CoV-2 infection remains unknown, as systematic screening for PE is cumbersome. We performed a systematic review and meta-analysis on autoptic data to estimate the prevalence of histopathologic findings of acute PE and its relevance as a cause of death on patients with COVID-19. We searched MEDLINE-PubMed and Scopus to locate all articles published in the English language, up to August 10, 2021, reporting the autoptic prevalence of acute PE and evaluating PE as the underlying cause of death in patients with COVID-19. The pooled prevalence for both outcomes was calculated using a random-effects model and presenting the related 95% confidence interval (CI). Statistical heterogeneity was measured using the Higgins I statistic. We analyzed autoptic data of 749 patients with COVID-19 (mean age 63.4 years) included in 14 studies. In 10 studies, based on 526 subjects (mean age 63.8 years), a random-effect model revealed that autoptic acute PE findings were present in 27.5% of cases (95% CI 15.0 to 45.0%, I 89.9%). Conversely, in 429 COVID-19 subjects (mean age 64.0 years) enrolled in 9 studies, acute PE was the underlying cause of death in 19.9% of cases (95% CI 11.0 to 33.3%, I 83.3%). Autoptic findings of acute PE in patients with COVID-19 are present in about 30% of subjects, whereas a venous thromboembolic event represents the underlying cause of death in about 1 of 4 patients.
截至目前，SARS-CoV-2 感染患者中急性肺栓塞（PE）的实际患病率尚不清楚，因为对 PE 的系统筛查很繁琐。我们对尸检数据进行了系统回顾和荟萃分析，以评估 COVID-19 患者中急性 PE 的组织病理学发现的患病率及其作为死亡原因的相关性。我们在 MEDLINE-PubMed 和 Scopus 上搜索了截至 2021 年 8 月 10 日以英文发表的所有文章，报道了急性 PE 的尸检患病率，并评估了 PE 作为 COVID-19 患者的潜在死亡原因。使用随机效应模型计算了这两个结果的合并患病率，并呈现了相关的 95%置信区间（CI）。使用 Higgins I 统计量衡量统计异质性。我们分析了 14 项研究中纳入的 749 例 COVID-19 患者（平均年龄 63.4 岁）的尸检数据。在 10 项研究中，基于 526 名患者（平均年龄 63.8 岁），随机效应模型显示尸检急性 PE 发现存在于 27.5%的病例中（95%CI 15.0 至 45.0%，I 89.9%）。相反，在纳入 9 项研究的 429 名 COVID-19 患者（平均年龄 64.0 岁）中，急性 PE 是 19.9%病例的潜在死亡原因（95%CI 11.0 至 33.3%，I 83.3%）。COVID-19 患者的尸检中急性 PE 发现存在于大约 30%的患者中，而静脉血栓栓塞事件是大约 1/4 患者的潜在死亡原因。
