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Risk of venous thromboembolism in patients with COVID‐19: A systematic review and meta‐analysis

Research and Practice in Thrombosis and Haemostasis, 2020-10, Vol.4 (7), p.1178-1191 [Peer Reviewed Journal]

2020 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH). ;2020 The Authors. published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH). ;2020. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 2475-0379 ;EISSN: 2475-0379 ;DOI: 10.1002/rth2.12439 ;PMID: 33043231

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  • Title:
    Risk of venous thromboembolism in patients with COVID‐19: A systematic review and meta‐analysis
  • Author: Nopp, Stephan ; Moik, Florian ; Jilma, Bernd ; Pabinger, Ingrid ; Ay, Cihan
  • Subjects: Bias ; Coronaviruses ; COVID-19 ; Intensive care ; Original ; Original ‐ Thrombosis ; Patients ; prevalence ; pulmonary embolism ; Pulmonary embolisms ; Severe acute respiratory syndrome coronavirus 2 ; Systematic review ; Thromboembolism ; Thrombosis ; Ultrasonic imaging ; venous thromboembolism
  • Is Part Of: Research and Practice in Thrombosis and Haemostasis, 2020-10, Vol.4 (7), p.1178-1191
  • Description: Venous thromboembolism (VTE) is frequently observed in patients with coronavirus disease 2019 (COVID‐19). However, reported VTE rates differ substantially. We aimed at evaluating available data and estimating the prevalence of VTE in patients with COVID‐19. We conducted a systematic literature search (MEDLINE, EMBASE, World Health Organization COVID‐19 database) to identify studies reporting VTE rates in patients with COVID‐19. Studies with suspected high risk of bias were excluded from quantitative synthesis. Pooled outcome rates were obtained within a random effects meta‐analysis. Subgroup analyses were performed for different settings (intensive care unit [ICU] vs non‐ICU hospitalization and screening vs no screening) and the association of d‐dimer levels and VTE risk was explored. Eighty‐six studies (33,970 patients) were identified and 66 (28,173 patients, mean age: 62.6 years, 60.1% men, 19.4% ICU patients) were included in quantitative analysis. The overall VTE prevalence estimate was 14.1% (95% confidence interval [CI], 11.6‐16.9), 40.3% (95% CI, 27.0‐54.3) with ultrasound screening and 9.5% (95% CI, 7.5‐11.7) without screening. Subgroup analysis revealed high heterogeneity, with a VTE prevalence of 7.9% (95% CI, 5.1‐11.2) in non‐ICU and 22.7% (95% CI, 18.1‐27.6) in ICU patients. Prevalence of pulmonary embolism (PE) in non‐ICU and ICU patients was 3.5% (95% CI, 2.2‐5.1) and 13.7% (95% CI, 10.0‐17.9). Patients developing VTE had higher d‐dimer levels (weighted mean difference, 3.26 µg/mL; 95% CI, 2.76‐3.77) than non‐VTE patients. VTE occurs in 22.7% of patients with COVID‐19 in the ICU, but VTE risk is also increased in non‐ICU hospitalized patients. Patients developing VTE had higher d‐dimer levels. Studies evaluating thromboprophylaxis strategies in patients with COVID‐19 are needed to improve prevention of VTE.
  • Publisher: United States: Elsevier Inc
  • Language: English
  • Identifier: ISSN: 2475-0379
    EISSN: 2475-0379
    DOI: 10.1002/rth2.12439
    PMID: 33043231
  • Source: Coronavirus Research Database
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