tetano
Editor, Senior Moderator
Eur Respir J
. 2022 Aug 18;2200619.
doi: 10.1183/13993003.00619-2022. Online ahead of print.
COVID-19 infection and its impact on case-fatality in patients with pulmonary embolism
Lukas Hobohm[SUP] 1 2 3 [/SUP], Ingo Sagoschen[SUP] 4 3 [/SUP], Stefano Barco[SUP] 2 5 [/SUP], Ioannis T Farmakis[SUP] 2 6 [/SUP], Ugo Fedeli[SUP] 7 [/SUP], Sebastian Koelmel[SUP] 8 [/SUP], Tommaso Gori[SUP] 4 [/SUP], Christine Espinola-Klein[SUP] 4 [/SUP], Thomas Münzel[SUP] 4 9 [/SUP], Stavros Konstantinides[SUP] 2 10 [/SUP], Karsten Keller[SUP] 4 2 11 [/SUP]
Affiliations
Abstract
Background: Although a high prevalence of pulmonary embolism (PE) has been reported in association with coronavirus disease (COVID)-19 in critically ill patients, nationwide data on the outcome of hospitalised patients with COVID-19 and PE is still limited. Thus, we investigated seasonal trends and predictors of in-hospital death in patients with COVID-19 and PE in Germany.
Methods: We used the German nationwide inpatient sample to analyse data on hospitalisations among COVID-19 patients with and without PE during 2020, and to detect changes in PE prevalence and case fatality in comparison to 2019.
Results: We analysed 176,137 COVID-19 hospitalisations in 2020; PE was recorded in 1.9% (n=3362) of discharge certificates. Almost one third of patients with COVID-19 and PE died during the in-hospital course (28.7%) compared to COVID-19 patients without PE (17.7%). Between 2019 and 2020, numbers of PE-related hospitalisations were largely unchanged (98,485 versus 97,718), whereas the case-fatality rate of PE increased slightly in 2020 (from 12.7% to 13.1%, p<0.001). Differences in case fatality were found between PE patients with and without COVID-19 in 2020 (28.7% versus 12.5%, p<0.001), corresponding to a 3.1-fold increased risk of PE-related death (OR 3.16, 95% CI 2.91-3.42, p<0.001) in the presence of COVID-19.
Conclusions: In Germany, the prevalence of PE events during hospitalisations was similar in 2019 and 2020. However, the fatality rate among patients with both COVID-19 and PE was substantially higher than that in those with only one of these diseases, suggesting a life-threatening additive prognostic impact of the COVID-PE combination.
. 2022 Aug 18;2200619.
doi: 10.1183/13993003.00619-2022. Online ahead of print.
COVID-19 infection and its impact on case-fatality in patients with pulmonary embolism
Lukas Hobohm[SUP] 1 2 3 [/SUP], Ingo Sagoschen[SUP] 4 3 [/SUP], Stefano Barco[SUP] 2 5 [/SUP], Ioannis T Farmakis[SUP] 2 6 [/SUP], Ugo Fedeli[SUP] 7 [/SUP], Sebastian Koelmel[SUP] 8 [/SUP], Tommaso Gori[SUP] 4 [/SUP], Christine Espinola-Klein[SUP] 4 [/SUP], Thomas Münzel[SUP] 4 9 [/SUP], Stavros Konstantinides[SUP] 2 10 [/SUP], Karsten Keller[SUP] 4 2 11 [/SUP]
Affiliations
- PMID: 35981745
- DOI: 10.1183/13993003.00619-2022
Abstract
Background: Although a high prevalence of pulmonary embolism (PE) has been reported in association with coronavirus disease (COVID)-19 in critically ill patients, nationwide data on the outcome of hospitalised patients with COVID-19 and PE is still limited. Thus, we investigated seasonal trends and predictors of in-hospital death in patients with COVID-19 and PE in Germany.
Methods: We used the German nationwide inpatient sample to analyse data on hospitalisations among COVID-19 patients with and without PE during 2020, and to detect changes in PE prevalence and case fatality in comparison to 2019.
Results: We analysed 176,137 COVID-19 hospitalisations in 2020; PE was recorded in 1.9% (n=3362) of discharge certificates. Almost one third of patients with COVID-19 and PE died during the in-hospital course (28.7%) compared to COVID-19 patients without PE (17.7%). Between 2019 and 2020, numbers of PE-related hospitalisations were largely unchanged (98,485 versus 97,718), whereas the case-fatality rate of PE increased slightly in 2020 (from 12.7% to 13.1%, p<0.001). Differences in case fatality were found between PE patients with and without COVID-19 in 2020 (28.7% versus 12.5%, p<0.001), corresponding to a 3.1-fold increased risk of PE-related death (OR 3.16, 95% CI 2.91-3.42, p<0.001) in the presence of COVID-19.
Conclusions: In Germany, the prevalence of PE events during hospitalisations was similar in 2019 and 2020. However, the fatality rate among patients with both COVID-19 and PE was substantially higher than that in those with only one of these diseases, suggesting a life-threatening additive prognostic impact of the COVID-PE combination.