Incidence of acute pulmonary embolism among patients hospitalized with COVID-19: a systematic review and meta-analysis

Mohamed S. Munner, Charles A. Ritchie, Ibrahim H. Elkhidir, Doaa T. Mohammadat, Hussein J. Ahmed, Khalid A. Altayeb, Rawan Z. Yassin, Riyan M. Hassan, Saada A. Hamad, Mohammed Nimir, Osman S. Hamid, Margaret M. Johnson, Tathagat Narula, Young Erben, Rabih G. Tawk, David A. Miller, Vivek Gupta, Zlatko Devcic, William D Freeman, Beau B. Toskich

Research output: Contribution to journalReview articlepeer-review


Background: Coronavirus disease 2019 (COVID-19) is a global pandemic, which is associated with venous thromboembolism and pulmonary embolism (PE). This study aimed to estimate the pooled incidence of PE among patients hospitalized with COVID-19 within the published literature. Methods: This systematic review and meta-analysis was performed according to PRISMA guidelines. An electronic search using MEDLINE /PubMed, ScienceDirect, Cochrane, and OpenGray databases was conducted May 19th, 2020. Eligible studies included sufficient data to calculate the incidence of PE diagnosed during hospitalization in patients with COVID-19. Case reports were excluded. Quality was assessed using the Newcastle-Ottawa scale (observational cohort and case-control), AXIS tool (cross-sectional), and quality assessment tool (case series). Demographics and PE incidence data were extracted from the included studies and analyzed with R language. The pooled incidence of PE in patients hospitalized with COVID-19 was calculated. Results: The database search identified 128 records. Ten observational studies were eligible and were included in the meta-analysis with a total of 1722 patients (mean age= 63.36).The incidence of PE was noted to be higher in males. The D-dimer levels were specified between PE group and non-PE group in only three studies, while the remaining either reported it improperly or had missing data.The pooled PE incidence in patients hospitalized with COVID-19 was 17% (95% CI: 0.1-0.26). There was a high degree of study heterogeneity (I2 = 94%, p<0.01). Conclusion: The pooled PE incidence in patients hospitalized with COVID-19 is 17%. This increased incidence is greater than that previously reported in the general population of non-COVID-19. Attention and further investigation of this risk is warranted.

Original languageEnglish (US)
Article number1489
StatePublished - 2021


  • Coronavirus
  • COVID-19
  • Incidence
  • Meta-analysis
  • Pulmonary Embolism
  • Venous thromboembolism

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)


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