Zhong Xiaomin, Webster James, Morris Eva J A, Oguzman Emre, Shapiro Susan, Shepperd Sasha, Goldacre Raph
Applied Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Lancet Reg Health Eur. 2025 Sep 2;58:101433. doi: 10.1016/j.lanepe.2025.101433. eCollection 2025 Nov.
COVID-19 infection increases the risk of pulmonary embolism (PE). Up-to-date reporting of hospitalisation rates for PE is needed to inform service planning and for benchmarking in light of the pandemic. Our primary aim was to quantify monthly trends in first-time, hospital-recorded PE across England from 2008 to 2024, with particular focus on the pandemic period. A secondary aim was to examine how these trends varied by age, sex, socioeconomic deprivation, and region, providing ongoing public access through an interactive online dashboard.
We conducted an epidemiological population-based study of all first-time PE diagnoses using English national secondary care data from April 2008 to December 2024. Trends before and after the onset of the COVID-19 pandemic (March 2020) were compared, with analyses by age, sex, region, and deprivation.
A total of 750,109 first-time PE admissions were identified. Age-standardised first-time hospital-recorded PE rates rose from 5.4 per 100,000 population in April 2008 to 8.5 in January 2020, spiked to 16.8 in January 2021 during the pandemic. The spike was largely accounted for by PEs where COVID-19 was a co-existing diagnosis. Rates have since declined, returning to pre-pandemic levels by early 2023 (e.g. March 2023, 8.6 per 100,000), and may be continuing to decline, subject to further updates. Regional and deprivation gradients persisted throughout but were more pronounced during the pandemic.
Whilst incidence of hospital-recorded PE spiked during the COVID-19 pandemic, rates have since returned to levels observed immediately prior to the pre-pandemic. Whilst it is too early to determine whether the recent downward trend may begin to reverse some of the upward trend observed over the decade before the pandemic, continued surveillance of hospital-recorded PE reported via our online tool will keep these findings up to date. Ongoing monitoring of PE incidence by healthcare setting is important to undertake while clinical practice and policy on PE management pathways evolve, since it helps to support care planning; it also informs data-enabled clinical trials where PE is an outcome as well as the design of observational studies.
This work was supported by the NIHR Biomedical Research Centre, Oxford and by Health Data Research UK.
新型冠状病毒肺炎（COVID-19）感染会增加肺栓塞（PE）的风险。需要及时报告PE的住院率，以便为服务规划提供信息，并在大流行背景下进行基准对比。我们的主要目标是量化2008年至2024年英格兰首次医院记录的PE的月度趋势，特别关注大流行时期。次要目标是研究这些趋势在年龄、性别、社会经济剥夺程度和地区方面如何变化，并通过交互式在线仪表板为公众持续提供数据。
我们利用2008年4月至2024年12月的英国国家二级医疗数据，对所有首次PE诊断进行了基于人群的流行病学研究。比较了COVID-19大流行（2020年3月）前后的趋势，并按年龄、性别、地区和剥夺程度进行分析。
共确定了750,109例首次PE住院病例。年龄标准化的首次医院记录的PE发病率从2008年4月的每10万人5.4例上升到2020年1月的8.5例，在大流行期间的2021年1月飙升至16.8例。此次飙升主要是由合并COVID-19诊断的PE病例导致的。此后发病率有所下降，到2023年初（如2023年3月，每10万人8.6例）恢复到大流行前的水平，并且可能还在继续下降，有待进一步更新数据。地区和剥夺程度梯度在整个期间都存在，但在大流行期间更为明显。
虽然医院记录的PE发病率在COVID-19大流行期间飙升，但此后已恢复到大流行前即刻观察到的水平。虽然现在判断近期的下降趋势是否会开始扭转大流行前十年观察到的上升趋势还为时过早，但通过我们的在线工具持续监测医院记录的PE情况将使这些发现保持最新。在PE管理途径的临床实践和政策不断发展的过程中，持续监测医疗机构中的PE发病率很重要，因为这有助于支持护理规划；它还为以PE为结果的数据驱动型临床试验以及观察性研究的设计提供信息。
这项工作得到了英国国家卫生研究院生物医学研究中心牛津分部以及英国健康数据研究中心的支持。
