The incidence of pulmonary thromboembolism in COVID-19 patients admitted to the intensive care unit: a meta-analysis and meta-regression of observational studies

Journal of Intensive Care

Zhen Chang Liang¹  Jun Jie Ng²  Andrew M. T. L. Choong² 

[1] Department of Orthopaedic Surgery, National University Hospital, Singapore, Singapore;Division of Vascular and Endovascular Surgery, Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Level 9, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Singapore;Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore;SingVaSC, Singapore Vascular Surgical Collaborative, Singapore, Singapore;

关键词: Coronavirus disease 2019;    COVID-19;    Pulmonary thromboembolism;    Intensive care unit;    Critical care;   

DOI  :  10.1186/s40560-021-00535-x

来源: Springer

【 摘 要 】

ObjectivesCoronavirus disease 2019 (COVID-19) infection is associated with a prothrombotic state. We performed a meta-analysis of proportions to estimate the weighted average incidence of pulmonary thromboembolism (PTE) in COVID-19 patients who were admitted to the intensive care unit (ICU).MethodsWe searched various medical databases for relevant studies from 31 December 2019 till 30 September 2020. We included observational studies that reported the incidence of PTE in COVID-19 patients admitted to the ICU. We extracted data related to study characteristics, patient demographics, and the incidence of PTE. Risk of bias was assessed by using the ROBINS-I tool. Statistical analysis was performed with R 3.6.3.ResultsWe included 14 studies with a total of 1182 patients in this study. Almost all patients in this meta-analysis received at least prophylactic anticoagulation. The weighted average incidence of PTE was 11.1% (95% CI 7.7% to 15.7%, I2 = 78%, Cochran’s Q test P < 0.01). We performed univariate and multivariate meta-regression, which identified the proportion of males as a significant source of heterogeneity (P = 0.03, 95% CI 0.00 to − 0.09)ConclusionThe weighted average incidence of PTE remains high even after prophylactic anticoagulation. PTE is a significant complication of COVID-19 especially in critically ill patients in the ICU.

【 授权许可】

CC BY