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Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series

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submitted on 2024-02-25, 07:41 and posted on 2024-02-25, 07:42 authored by Hassan Choudry, Fateen Ata, Wanis Ibrahim, Mohammad Omer Rehman Rana, Shoaib Ahmad, Asim Mehmood, Basir Afzaal Gill, Mahammed Khan Suheb

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.

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Published in: Open Medicine
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Open Access funding provided by the Qatar National Library.



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Publication Year

  • 2023

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This Item is licensed under the Creative Commons Attribution 4.0 International License.

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  • Hamad Medical Corporation
  • Hamad General Hospital - HMC

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