Data_Sheet_1_Incidence of Venous Thromboembolism in Hospitalized Coronavirus Disease 2019 Patients: A Systematic Review and Meta-Analysis.PDF (524.31 kB)

Data_Sheet_1_Incidence of Venous Thromboembolism in Hospitalized Coronavirus Disease 2019 Patients: A Systematic Review and Meta-Analysis.PDF

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posted on 06.08.2020 by Chi Zhang, Long Shen, Ke-Jia Le, Mang-Mang Pan, Ling-Cong Kong, Zhi-Chun Gu, Hang Xu, Zhen Zhang, Wei-Hong Ge, Hou-Wen Lin

Background: Emerging evidence shows that coronavirus disease 2019 (COVID-19) is commonly complicated by coagulopathy, and venous thromboembolism (VTE) is considered to be a potential cause of unexplained death. Information on the incidence of VTE in COVID-19 patients, however, remains unclear.

Method: English-language databases (PubMed, Embase, Cochrane), Chinese-language databases (CNKI, VIP, WANFANG), and preprint platforms were searched to identify studies with data of VTE occurrence in hospitalized COVID-19 patients. Pooled incidence and relative risks (RRs) of VTE were estimated by a random-effects model. Variations were examined based on clinical manifestations of VTE (pulmonary embolism-PE and deep vein thrombosis-DVT), disease severity (severe patients and non-severe patients), and rate of pharmacologic thromboprophylaxis (≥60 and <60%). Sensitivity analyses were conducted to strengthen the robustness of results. Meta-regression was performed to explore the risk factors associated with VTE in COVID-19 patients.

Results: A total of 17 studies involving 1,913 hospitalized COVID-19 patients were included. The pooled incidence of VTE was 25% (95% CI, 19–31%; I2, 95.7%), with a significant difference between the incidence of PE (19%; 95% CI, 13–25%; I2, 93.2%) and DVT (7%; 95% CI, 4–10%; I2, 88.3%; Pinteraction < 0.001). Higher incidence was observed in severe COVID-19 patients (35%; 95 CI%, 25–44%; I2, 92.4%) than that in non-severe patients (6%; 95 CI%, 3–10%; I2, 62.2%; Pinteraction < 0.001). The high rate of pharmacologic thromboprophylaxis in COVID-19 patients (≥60%) was associated with a lower incidence of VTE compared with the low pharmacologic thromboprophylaxis rate (<60%) (19 vs. 40%; Pinteraction = 0.052). Severe patients had a 3.76-fold increased risk of VTE compared with non-severe patients (RR, 4.76; 95% CI, 2.66–8.50; I2, 47.0%). Sensitivity analyses confirmed the robustness of the primacy results.

Conclusions: This meta-analysis revealed that the estimated VTE incidence was 25% in hospitalized COVID-19 patients. Higher incidence of VTE was observed in COVID-19 patients with a severe condition or with a low rate of pharmacologic thromboprophylaxis. Assessment of VTE risk is strongly recommended in COVID-19 patients, and effective measures of thromboprophylaxis should be taken in a timely manner for patients with high risk of VTE.

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