Does Pulmonary Embolism in Critically Ill COVID-19 Patients Worsen the In-Hospital Mortality: A Meta-Analysis

Background: Mortality in critically ill COVID (coronavirus disease) patients secondary to pulmonary embolism (PE) has conflicting data. We aim to evaluate the mortality outcomes of critically ill patients with and without PE (WPE). Methods: Three studies were identified after a digital database search on PE in ICU (intensive care unit) patients until September 2020. The primary outcome was mortality. Outcomes were compared using a random method odds ratio and confidence interval of 95%. Results: A total of 439 patients were included in the study. Diabetes, hypertension, and renal replacement requirement had no statistically significant association between PE and WPE, p=0.39, p=0.23, and p=0.29 respectively. The study revealed that males have higher odds of PE, OR-1.98, 95%CI-1.01-3.89; p=0.05. In-hospital mortality results were comparable between PE andWPE after subgroup analysis and correction of heterogeneity, p=0.25. Conclusion: PE in critically ill COVID patients had similar in-hospital mortality outcomes as WPE patients. The findings are only hypotheses generated from observational studies and need future randomized, prospective clinical trials for a definitive conclusion. (C) 2020 Elsevier Inc. All rights reserved.