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Pulmonary thromboembolic events in COVID-19-A systematic literature review.
Overton, Paul M; Toshner, Mark; Mulligan, Claire; Vora, Pareen; Nikkho, Sylvia; de Backer, Jan; Lavon, Ben R; Klok, Frederikus A.
  • Overton PM; Beacon Medical Communications Ltd Brighton UK.
  • Toshner M; Department of Medicine, School of Clinical Medicine University of Cambridge Cambridge UK.
  • Mulligan C; Beacon Medical Communications Ltd Brighton UK.
  • Vora P; Bayer AG Berlin Germany.
  • Nikkho S; Bayer AG Berlin Germany.
  • de Backer J; FLUIDDA New York City New York USA.
  • Lavon BR; FLUIDDA New York City New York USA.
  • Klok FA; Department of Medicine-Thrombosis and Hemostasis Leiden University Medical Center Leiden the Netherlands.
Pulm Circ ; 12(3): e12113, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1925991
ABSTRACT
Pulmonary thromboembolic events 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 May 7, 2021. Hospital cohort and database studies reporting data for ≥1000 patients and autopsy studies reporting data for ≥20 patients were included. Results were summarized descriptively. We screened 1438 records and included 41 references (32 hospital/database studies and 9 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 focused 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.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid Language: English Journal: Pulm Circ Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid Language: English Journal: Pulm Circ Year: 2022 Document Type: Article