Predictive scores for the diagnosis of Pulmonary Embolism in COVID-19: A systematic review

Int J Infect Dis. 2022 Feb;115:93-100. doi: 10.1016/j.ijid.2021.11.038. Epub 2021 Nov 27.


Objectives: During the COVID-19 pandemic, several studies described an increased chance of developing pulmonary embolism (PE). Several scores have been used to predict the occurrence of PE. This systematic review summarizes the literature on predicting rules for PE in hospitalized COVID-19 patients (HCPs).

Methods: PUBMED and EMBASE databases were searched to identify articles (1 January 2020-28 April 2021) presenting data pertaining to the use of a prediction rule to assess the risk for PE in adult HCPs. The investigated outcome was the diagnosis of PE. Studies presenting data using a single laboratory assay for PE prediction were excluded. Included studies were appraised for methodological quality using the Newcastle - Ottawa Quality Assessment Scale for Cohort Studies (NOS).

Results: We obtained a refined pool of twelve studies for five scoring systems (Wells score, Geneva score, CHADS2/CHA2DS2VASc/M-CHA2DS2VASc, CHOD score, Padua Prediction Score), and 4,526 patients. Only one score was designed explicitly for HCPs. Three and nine included studies were prospective and retrospective cohort studies, respectively. Among the examined scores, the CHOD score seems promising for predictive ability.

Conclusion: New prediction rules, specifically developed and validated for estimating the risk of PE in HCP, differentiating ICU from non-ICU patients, and taking into account anticoagulation prophylaxis, comorbidities, and the time from COVID-19 diagnosis are needed.

Keywords: COVID-19; SARS-CoV2; prediction rule; pulmonary embolism; score; thromboembolism.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • COVID-19 Testing
  • COVID-19*
  • Humans
  • Pandemics
  • Predictive Value of Tests
  • Prospective Studies
  • Pulmonary Embolism* / diagnosis
  • Pulmonary Embolism* / epidemiology
  • Retrospective Studies
  • SARS-CoV-2