Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Oct:31:34-40.
doi: 10.1016/j.carrev.2020.11.024. Epub 2020 Nov 25.

Does Pulmonary Embolism in Critically Ill COVID-19 Patients Worsen the In-Hospital Mortality: A Meta-Analysis

Tanveer Mir  1 , Hassan Bin Attique  2 , Yasar Sattar  3 , Neelambuj Regmi  4 , Muhammad Shayan Khan  5 , Haris Youns  6 , Basharat Qayoom  7 , Michael T Jerger  4 , M Chadi Alraies  8
Affiliations
Meta-Analysis

Does Pulmonary Embolism in Critically Ill COVID-19 Patients Worsen the In-Hospital Mortality: A Meta-Analysis

Tanveer Mir et al. Cardiovasc Revasc Med. 2021 Oct.

Abstract

Background: Mortality in critically ill COVID (coronavirus disease) patients secondary to pulmonary embolism (PE) has conflicting data. We aim to evaluate the mortality outcomes of critically ill patients with and without PE (WPE).

Methods: Three studies were identified after a digital database search on PE in ICU (intensive care unit) patients until September 2020. The primary outcome was mortality. Outcomes were compared using a random method odds ratio and confidence interval of 95%.

Results: A total of 439 patients were included in the study. Diabetes, hypertension, and renal replacement requirement had no statistically significant association between PE and WPE, p = 0.39, p = 0.23, and p = 0.29 respectively. The study revealed that males have higher odds of PE, OR-1.98, 95%CI-1.01-3.89; p = 0.05. In-hospital mortality results were comparable between PE and WPE after subgroup analysis and correction of heterogeneity, p = 0.25.

Conclusion: PE in critically ill COVID patients had similar in-hospital mortality outcomes as WPE patients. The findings are only hypotheses generated from observational studies and need future randomized, prospective clinical trials for a definitive conclusion.

Keywords: Coronavirus; Critically ill patients; Pulmonary embolism.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest None. No funding was required for the project.

Figures

Fig. 1
Fig. 1
PRISMA flow chart for selection of studies.
Fig. 2
Fig. 2
a. Summary of methodological quality of the included studies. b. Risk of methodological bias across at the level of included studies.
Fig. 3
Fig. 3
a. Forest plot comparing diabetes for PE and WPE. The odds of association of diabetes were comparable between the two groups. b. Forest plot comparing Hypertension for PE and WPE. The odds of association with hypertension were comparable between the two groups. c. Forest plot comparing sex distribution for PE and WPE. The odds of association of PE with male sex in critically ill COVID patients are higher and statistically significant than WPE.
Fig. 4
Fig. 4
a. Forest plot comparing renal replacement therapy (RRT) for PE and WPE. The odds of association of RRT were comparable between the two groups. b. Forest plot comparing neuromuscular block use (NMB) for PE and WPE. The odds of association of NMB use were comparable between the two groups.
Fig. 5
Fig. 5
Forest plot comparing mortality outcomes for PE and WPE. The results were comparable between the two groups.
Fig. 6
Fig. 6
Funnel plot for publication bias. No significant scatter is visible.
See this image and copyright information in PMC

References

    1. Chan J.F., Yuan S., Kok K.H., To K.K., Chu H., Yang J., et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514–523. - PMC - PubMed
    1. Taccone F.S., Gevenois P.A., Peluso L., Pletchette Z., Lheureux O., Brasseur A., et al. Higher intensity thromboprophylaxis regimens and pulmonary embolism in critically Ill coronavirus disease 2019 patients. Crit Care Med. 2020;48:e1087–e1090. - PMC - PubMed
    1. Gattinoni L., Coppola S., Cressoni M., Busana M., Rossi S., Chiumello D. COVID-19 does not Lead to a “typical” acute respiratory distress syndrome. Am J Respir Crit Care Med. 2020;201(10):1299–1300. - PMC - PubMed
    1. Sattar Y., Ullah W., Rauf H., Virk H.U.H., Yadav S., Chowdhury M., et al. COVID-19 cardiovascular epidemiology, cellular pathogenesis, clinical manifestations and management. Int J Cardiol Heart Vasc. 2020;29:100589. - PMC - PubMed
    1. Morrone D., Morrone V. Acute pulmonary embolism: focus on the clinical picture. Korean Circ J. 2018;48(5):365–381. - PMC - PubMed

Publication types