There is an increased risk of venous thromboembolism among patients with COVID-19 infection, with the risk being higher among those needing intensive level of care. Existing data is, however limited regarding the outcomes of patients admitted with concurrent COVID-19 infection and pulmonary embolism (PE).
All acute PE admissions were identified from the National Inpatient Sample database during 2020 using ICD-10 codes. Patients were subsequently classified into those with and without COVID-19 infection. The primary outcome of interest was in-hospital mortality. Using multivariate logistic regression, the predictors of mortality were assessed for patients with concurrent acute PE and COVID-19.
The database query generated 278,840 adult patients with a primary diagnosis of PE. Of these, 4580 patients had concurrent PE and COVID-19 infection. The concurrent PE and COVID-19 infection group had a higher proportion of Black-American and Hispanic patients, and those living in the zip codes associated with lowest annualized income compared to the PE alone group. Furthermore, patients in the concurrent PE and COVID-19 infection group had an increased risk of in-hospital mortality (adjusted odds ratio [aOR]:1.62; 95% CI: 1.17 – 2.24; p = 0.004), septic shock (aOR: 1.66; 95% CI 1.10-2.52; p = 0.016), respiratory failure (aOR: 1.78; 95% CI 1.53-2.06; p = 0.001), and a longer hospital stay [5.5 days vs 4.59 days; p = 0.001).
Concurrent COVID-19 and PE admissions is associated with an increased in-hospital mortality, risk of septic shock and respiratory failure, and a longer length of hospital stay.
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