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Meta-Analysis
. 2022 Mar 14;17(3):e0263580.
doi: 10.1371/journal.pone.0263580. eCollection 2022.

Incidence and prognostic value of pulmonary embolism in COVID-19: A systematic review and meta-analysis

Xiaowei Gong  1 , Boyun Yuan  1 , Yadong Yuan  1
Affiliations
Meta-Analysis

Incidence and prognostic value of pulmonary embolism in COVID-19: A systematic review and meta-analysis

Xiaowei Gong et al. PLoS One. .

Abstract

Background: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1
Fig 1. The flow diagram for the literature search and study selection.
Fig 2
Fig 2. The pooled incidence of pulmonary embolism in COVID-19 patients.
Fig 3
Fig 3. Pooled sensitivity and specificity for pulmonary embolism on subsequent ICU admission.
Fig 4
Fig 4. Pooled PLR and NLR for pulmonary embolism on subsequent ICU admission.
Fig 5
Fig 5. Pooled DOR for pulmonary embolism on subsequent ICU admission.
Fig 6
Fig 6. AUC for the role of pulmonary embolism in intensive care unit (ICU) admission.
Fig 7
Fig 7
Funnel plot for the incidence of pulmonary embolism (A) and the predictive value of pulmonary embolism for ICU admission (B).
See this image and copyright information in PMC

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