Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis
- PDF / 820,311 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 61 Downloads / 161 Views
RESEARCH
Open Access
Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis Kochawan Boonyawat1* , Pichika Chantrathammachart1, Pawin Numthavej2, Nithita Nanthatanti3, Sithakom Phusanti3, Angsana Phuphuakrat1, Pimjai Niparuck1 and Pantep Angchaisuksiri1
Abstract Background: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the incidence of thromboembolism has been increasingly reported. The aim of this systematic review was to explore the incidence of venous and arterial thromboembolism among COVID-19 patients requiring hospitalization. Methods: Medline, Embase, Scopus, and grey literature were searched until June 2020. Observational studies reported on the incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT) or arterial thromboembolism (ATE) were included. The pool incidences and their 95% confidence intervals (CI) were calculated using the random-effects model. Results: A total of 36 studies were included. In the intensive care unit (ICU) setting, the pooled incidence of VTE was 28% (95% CI, 22–34%). Subgroups based on compression ultrasound (CUS) screening revealed a higher incidence of DVT in the CUS screening group than in the no CUS screening group (32% [95% CI, 18–45%] vs. 6% [95% CI, 4–9%]). The pooled incidence of ATE in ICU was 3% (95% CI, 2–5%). In the non-ICU setting, the pooled incidence of VTE was 10% (95% CI, 6–14%,). Conclusions: The incidence of VTE in COVID-19 patients was higher in the ICU setting than in the non-ICU setting, and also significantly higher in studies that incorporated the CUS screening protocol. The incidence of ATE in the ICU setting was low. VTE prophylactic measures should be given to all hospitalized patients diagnosed with COVID-19. Keywords: COVID-19, Venous thromboembolism, Arterial thromboembolism, Meta-analysis
Background Since December 2019, coronavirus disease 2019 (COVID-19) has emerged as a pandemic, causing high morbidity and mortality. The association between coagulation abnormalities, including disseminated intravascular coagulation and hypercoagulable state, and COVID-19 has been increasingly reported. The proposed underlying mechanism is that coronavirus infection could * Correspondence: [email protected] 1 Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Full list of author information is available at the end of the article
activate multiple systemic coagulation and inflammatory responses. Host inflammatory responses result in increased proinflammatory cytokine production, which leads to activation of coagulation and consumptive coagulopathy [1]. Several observational studies demonstrated a higher incidence of venous thrombotic events in patients diagnosed with COVID-19 admitted to the intensive care unit (ICU) compared with those from historical data [2, 3]. For arterial thrombosis, sepsisinduced coagulopathy with vascular endothelial dysfunction could contribute to microcircula
Data Loading...
