Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
PLoS One. 2022 Mar 14;17(3):e0263580. doi: 10.1371/journal.pone.0263580. eCollection 2022.
Pulmonary embolisms are frequently and prognostically in individuals infected by coronavirus disease 2019 (COVID-19); the incidence of pulmonary embolisms is varied across numerous studies. This study aimed to assess the pooled incidence of pulmonary embolic events and the prognostic value of such events in intensive care unit (ICU) admissions of patients with COVID-19.
The Cochrane Library, PubMed, and EmBase were systematically searched for eligible studies published on or before October 20, 2021. The pooled incidence of pulmonary embolism was calculated using the random-effects model. Moreover, the prognostic value was assessed by measuring the sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curve (AUC).
Thirty-six studies involving 10,367 COVID-19 patients were selected for the final meta-analysis. The cumulative incidence of pulmonary embolism in patients with COVID-19 was 21% (95% confidence interval [95%CI]: 18-24%; P<0.001), and the incidence of pulmonary embolism in ICU and non-ICU patients was 26% (95%CI: 22-31%; P<0.001) and 17% (95%CI: 14-20%; P<0.001), respectively. The predictive role of pulmonary embolism in ICU admission was also assessed, and the sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.31 (95%CI: 0.21-0.42), 0.84 (95%CI: 0.75-0.90), 1.88 (95%CI: 1.45-2.45), 0.83 (95%CI: 0.75-0.91), 2.25 (95%CI: 1.64-3.08), and 0.61 (95%CI: 0.57-0.65), respectively.
This study found that the incidence of pulmonary embolism was relatively high in COVID-19 patients, and the incidence of pulmonary embolism in ICU patients was higher than that in non-ICU patients.
肺栓塞在感染 2019 年冠状病毒病（COVID-19）的个体中较为常见且具有预后意义；多项研究中肺栓塞的发生率存在差异。本研究旨在评估 COVID-19 患者入住重症监护病房（ICU）时肺栓塞事件的累积发生率和此类事件的预后价值。
系统检索了 Cochrane 图书馆、PubMed 和 Embase 上截至 2021 年 10 月 20 日发表的合格研究。使用随机效应模型计算肺栓塞的累积发生率。此外，通过测量敏感度、特异度、阳性和阴性似然比（PLR 和 NLR）、诊断比值比（DOR）和受试者工作特征曲线下面积（AUC）来评估预后价值。
最终纳入 36 项共涉及 10367 例 COVID-19 患者的研究进行汇总分析。COVID-19 患者肺栓塞的累积发生率为 21%（95%置信区间[95%CI]：18-24%；P<0.001），ICU 和非 ICU 患者肺栓塞的发生率分别为 26%（95%CI：22-31%；P<0.001）和 17%（95%CI：14-20%；P<0.001）。还评估了肺栓塞对 ICU 入院的预测作用，敏感度、特异度、PLR、NLR、DOR 和 AUC 分别为 0.31（95%CI：0.21-0.42）、0.84（95%CI：0.75-0.90）、1.88（95%CI：1.45-2.45）、0.83（95%CI：0.75-0.91）、2.25（95%CI：1.64-3.08）和 0.61（95%CI：0.57-0.65）。
本研究发现 COVID-19 患者的肺栓塞发生率相对较高，且 ICU 患者的肺栓塞发生率高于非 ICU 患者。
