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Meta-Analysis
. 2021 Oct:111:154-163.
doi: 10.1016/j.ijid.2021.08.017. Epub 2021 Aug 18.

Risk factors for pulmonary embolism in patients with COVID-19: a systemic review and meta-analysis

Li-Yan Cui  1 , Wen-Wen Cheng  2 , Zhi-Wei Mou  3 , Duan Xiao  1 , Yun-Yi Li  4 , Yu-Jie Li  5 , Wan-Ting Li  1 , Zhuo-Ming Chen  6
Affiliations
Meta-Analysis

Risk factors for pulmonary embolism in patients with COVID-19: a systemic review and meta-analysis

Li-Yan Cui et al. Int J Infect Dis. 2021 Oct.

Abstract

Purpose: To detect the risk factors for pulmonary embolism (PE) in patients with COVID-19.

Methods: Studies were searched for in PubMed, Cochrane Library, Web of Science, and EMBASE. Two authors independently screened articles and extracted data. The data were pooled by meta-analysis and three subgroup analyses were performed.

Results: Of the 2210 articles identified, 27 studies were included. Pooled analysis suggested that males (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.26-1.75, P = 0.000), obesity (OR 1.37, 95% CI 1.03-1.82, P = 0.033), mechanical ventilation (OR 3.34, 95% CI 1.90-5.86, P = 0.000), severe parenchymal abnormalities (OR 1.92, 95% CI 1.43-2.58, P = 0.000), ICU admission (OR 2.44, 95% CI 1.48-4.03, P = 0.000), and elevated D-dimer and white blood cell values (at two time points: hospital admission or closest to computed tomography pulmonary angiography) (P = 0.000) correlated with a risk for PE occurrence in COVID-19 patients. However, age and common comorbidities had no association with PE occurrence. Computed tomography pulmonary angiography, unclear-ratio/low-ratio, and hospitalization subgroups had consistent risk factors with all studies; however, other subgroups had fewer risk factors for PE.

Conclusions: Risk factors for PE in COVID-19 were different from the classic risk factors for PE and are likely to differ in diverse study populations.

Keywords: COVID-19; Pulmonary embolism; Risk factor; Venous thrombus embolism.

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Figures

Fig. 1
Fig. 1
Flow chart of article selection.
Fig. 2
Fig. 2
Meta-analysis of demographical factors associated with PE occurrence in COVID-19. A, Male; B, Obesity.
Fig. 3
Fig. 3
Meta-analysis of clinical factors associated with PE occurrence in COVID-19. A, Mechanical Ventilation; B, pulmonary parenchymal damage; C, ICU admission.
Fig. 4
Fig. 4
Meta-analysis of laboratory factors associated with PE occurrence in COVID-19. A, D-dimer closet to the CTPA examination; B, D-dimer at hospital admission; C, WBC values closet to the CTPA examination; D, WBC values at hospital admission. Abbreviations:CTPA, computer tomography pulmonary angiography; WBC, white blood cell
See this image and copyright information in PMC

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