鞍性肺栓塞(SPE)是一种罕见的肺栓塞,可导致血流动力学受损,导致猝死。由于缺乏这方面的大型前瞻性研究,对流行病学知之甚少,COVID-19相关SPE的预后和影响后者的因素。我们旨在描述与COVID-19相关的SPE,并量化和比较病例中的死亡率和影响死亡率的因素。我们共纳入25篇出版物,共35例。平均年龄为45±16.3岁,女性11岁,男性24岁。呼吸困难(82.5%),端骨(43.5%),咳嗽(43.5%)是最常见的症状,5例(21.7%)患者出现阻塞性休克。报告的平均氧(O2)饱和度为85.8%±11.9mmHg。高血压(26.1%),糖尿病(21.7%),深静脉血栓(21.7%)是最常见的合并症.在脑电图(S1QIIITII)和超声心动图检查中,有7例(30%)患者被识别出右心劳损。抗凝,溶栓,21例(91.3%)尝试经皮介入治疗,13(56.5%),和6例(26.1%),分别。尽管积极的管理,在我们较小的病例报告队列中,25例患者中有2例(8.7%)死亡。我们得出的结论是,尽管采取了积极的管理模式,COVID-19的SPE死亡率仍然很高。
Saddle pulmonary embolism (SPE) is a rare type of pulmonary embolism that can lead to hemodynamic compromise causing sudden deaths. Due to a dearth of large prospective studies in this area, little is known regarding the epidemiology, and prognosis and factors affecting the latter for COVID-19-associated SPE. We aimed to describe COVID-19-associated SPE and quantify and compare mortality and factors affecting mortality among the cases. We included a total of 25 publications with a total of 35 cases. The average age was 45 ± 16.3 years with 11 females and 24 males. Dyspnoea (82.5%), orthopnoea (43.5%), and cough (43.5%) were the most common symptoms, and obstructive shock was present in five (21.7%) patients. The average reported oxygen (O2) saturation was 85.8% ± 11.9 mm Hg. Hypertension (26.1%), diabetes (21.7%), and deep vein thrombosis (21.7%) were the most commonly reported comorbidities. Right heart strain was recognized in seven (30%) patients on electroencephalogram (S1QIIITIII) and 12 (52.2%) patients on echocardiogram. Anticoagulation, thrombolysis, and percutaneous intervention were tried in 21 (91.3%), 13 (56.5%), and 6 (26.1%) cases, respectively. Despite the aggressive management, 2 of 25 (8.7%) patients died in our smaller
case report cohort. We conclude that despite aggressive management modalities, the mortality of SPE remains high in COVID-19.