Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis.

Porfidia, Angelo; Valeriani, Emanuele; Pola, Roberto; Porreca, Ettore; Rutjes, Anne W.S.; Di Nisio, Marcello (2020). Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis. Thrombosis research, 196, pp. 67-74. Elsevier 10.1016/j.thromres.2020.08.020

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BACKGROUND

Venous thromboembolism (VTE) may complicate the course of Coronavirus Disease 2019 (COVID-19).

OBJECTIVES

To evaluate the incidence of VTE in patients with COVID-19.

METHODS

MEDLINE, EMBASE, and PubMed were searched up to 24th June 2020 for studies that evaluated the incidence of VTE, including pulmonary embolism (PE) and/or deep vein thrombosis (DVT), in patients with COVID-19. Pooled proportions with corresponding 95% confidence intervals (CI) and prediction intervals (PI) were calculated by random-effect meta-analysis.

RESULTS

3487 patients from 30 studies were included. Based on very low-quality evidence due to heterogeneity and risk of bias, the incidence of VTE was 26% (95% PI, 6%-66%). PE with or without DVT occurred in 12% of patients (95% PI, 2%-46%) and DVT alone in 14% (95% PI, 1%-75%). Studies using standard algorithms for clinically suspected VTE reported PE in 13% of patients (95% PI, 2%-57%) and DVT in 6% (95% PI, 0%-60%), compared to 11% (95% PI, 2%-46%) and 24% (95% PI, 2%-85%) in studies using other diagnostic strategies or patient sampling. In patients admitted to intensive care units, VTE occurred in 24% (95% PI, 5%-66%), PE in 19% (95% PI, 6%-47%), and DVT alone in 7% (95% PI, 0%-69%). Corresponding values in general wards were respectively 9% (95% PI, 0%-94%), 4% (95% PI, 0%-100%), and 7% (95% CI, 1%-49%).

CONCLUSIONS

VTE represents a frequent complication in hospitalized COVID-19 patients and often occurs as PE. The threshold for clinical suspicion should be low to trigger prompt diagnostic testing.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Rutjes, Anne

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0049-3848

Publisher:

Elsevier

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

01 Sep 2020 17:03

Last Modified:

25 Nov 2020 01:32

Publisher DOI:

10.1016/j.thromres.2020.08.020

PubMed ID:

32853978

Uncontrolled Keywords:

Anticoagulants COVID-19 Pulmonary embolism SARS virus Venous thromboembolism

BORIS DOI:

10.7892/boris.146261

URI:

https://boris.unibe.ch/id/eprint/146261

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