Pulmonary embolism detected by CT pulmonary angiography in hospitalized COVID-19 patients

Bunel, Vincent; Saker, Loukbi; Ajzenberg, Nadine; Timsit, Jean François; Najem, Samer; Lortat‐Jacob, Brice; Weisenburger, G.; Mal, Hervé; Khalil, Antoine

doi:10.1016/j.pulmoe.2021.03.007

Cited by 1 publication

(8 citation statements)

References 11 publications

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“…Most other analyses of hospitalized patients (17 of 20) identified in our literature search reported the incidence of PE to range from 1.0% to 3.6% 10,13–16,18,20,21,23,25–28,31,32,37 . Three studies found higher rates, of 5.7%–8.2%; this may reflect the possible inclusion of ICU patients, who were not reported separately 8,29,30 …”

Section: Resultsmentioning

confidence: 85%

“…34 Aktaa et al investigated UK hospital admissions for TE: the incidence of PE among admitted patients with COVID-19 was 886 per 100,000 admissions (0.89%) 33 Most other analyses of hospitalized patients (17 of 20) identified in our literature search reported the incidence of PE to range from 1.0% to 3.6%. 10,[13][14][15][16]18,20,21,23,[25][26][27][28]31,32,37 Three studies found higher rates, of 5.7%-8.2%; this may reflect the possible inclusion of ICU patients, who were not reported separately. 8,29,30…”

Section: Pe In Hospitalized Patientsmentioning

confidence: 92%

“…Across the included studies, PE was reported by a median of 0.4% of outpatients, [7][8][9][10][11][12][36][37][38] 2.3% of patients admitted to hospital, 8,10,[13][14][15][16][18][19][20][21][22][23][25][26][27][28][29][30][31][32][33][34][35]37 and 7.3% of patients treated in ICU 15,17,24,26,32 (Figure 2a). In analyses of patients who all underwent CTPA, PE was reported by a median of 34.2% of outpatients treated in ED, 11,12 8.3% of previously discharged outpatients (in a single study), 7 18.5% of hospitalized patients, 9,13,18,21,27,29,31 22.1% of hospitalized non-ICU ...…”

Section: Overall Incidence Of Pementioning

confidence: 99%

“…The locations of PEs were described in eight studies (Figure 3). 8,13,16,20,[27][28][29]32 In general, segmental arteries were the most common location for PE, although one study found that more than half of patients had lobar or proximal emboli. 28 Bilateral PE was frequent, with two studies reporting that the majority of patients with PE had bilateral emboli.…”

Section: Location Of Pementioning

confidence: 99%

“…A total of eight studies reported risk factors for the development of PE, or significant differences between groups of patients with and without PE (Table 2). 8,13,16,20,21,29,30,32 Significant risk factors for PE included male sex, older age, and mechanical ventilation, as well as higher C-reactive protein and D-dimer levels.…”

Section: Risk Factors For Development Of Pementioning

confidence: 99%

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Pulmonary thromboembolic events in COVID‐19—A systematic literature review

et al. 2022

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Pulmonary thromboembolic events (TE) have been linked to coronavirus disease 2019 (COVID‐19), but their incidence and long‐term sequelae remain unclear. We performed a systematic literature review to investigate the incidence of pulmonary embolism (PE), microthrombi, thrombosis in situ (thromboinflammatory disease) and chronic thromboembolic pulmonary hypertension (CTEPH) during and after COVID‐19. PubMed and the World Health Organization Global Research Database were searched on 7 May 2021. Hospital cohort and database studies reporting data for ≥ 1,000 patients and autopsy studies reporting data for ≥ 20 patients were included. Results were summarized descriptively. We screened 1,438 records and included 41 references (32 hospital/database studies and nine autopsy studies). The hospital/database studies reported the incidence of PE but not CTEPH, microthrombi or thromboinflammatory disease. PE incidence varied widely (0–1.1% of outpatients, 0.9–8.2% of hospitalized patients and 1.8–18.9% of patients in intensive care). One study reported PE events occurring within 45 days after hospital discharge (incidence in discharged patients: 0.2%). Segmental arteries were generally the most common location for PE. In autopsy studies, PE, thromboinflammatory disease and microthrombi were reported in 6–23%, 43–100% and 45–84% of deceased patients, respectively. Overall, the included studies mostly focussed on PE during the acute phase of COVID‐19. The results demonstrate the challenges of identifying and characterizing vascular abnormalities using current protocols (e.g. visual computed tomography reads). Further research is needed to detect subtle pulmonary vascular abnormalities, distinguish thromboinflammatory disease from PE, optimize treatment, and assess the incidence of long‐term sequelae after COVID‐19. This article is protected by copyright. All rights reserved.

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Section: Resultsmentioning

confidence: 85%