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Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis

Kochawan Boonyawat1, Pichika Chantrathammachart2, Pawin Numthavaj3

  • 1Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Kochawan.boo@mahidol.ac.th.

Thrombosis Journal
|December 9, 2020
PubMed

Insights

Hospitalized COVID-19 patients have a high incidence of venous thromboembolism (VTE), especially in the ICU. Prophylactic measures are recommended for all hospitalized COVID-19 patients to prevent VTE and arterial thromboembolism (ATE).

Area of Science:

  • Medicine
  • Public Health
  • Epidemiology

Background:

  • The COVID-19 pandemic has seen a rise in reported thromboembolism cases.
  • Understanding the incidence of venous and arterial thromboembolism in hospitalized COVID-19 patients is crucial.

Purpose of the Study:

  • To systematically review and explore the incidence of venous thromboembolism (VTE) and arterial thromboembolism (ATE) in hospitalized COVID-19 patients.

Main Methods:

  • A systematic review of Medline, Embase, Scopus, and grey literature was conducted until June 2020.
  • Included observational studies reporting on VTE (pulmonary embolism, deep vein thrombosis) or ATE incidence.
  • Pooled incidences and 95% confidence intervals (CI) were calculated using a random-effects model.

Main Results:

  • A total of 36 studies were analyzed.
  • The pooled incidence of VTE in the ICU was 28% (95% CI, 22-34%), significantly higher than in non-ICU settings (10%, 95% CI, 6-14%).
  • Deep vein thrombosis incidence was higher with compression ultrasound screening (32%) compared to no screening (6%). Arterial thromboembolism incidence in the ICU was 3% (95% CI, 2-5%).

Conclusions:

  • COVID-19 patients in the ICU have a higher VTE incidence than non-ICU patients.
  • Studies using compression ultrasound screening showed higher DVT rates.
  • VTE prophylaxis is recommended for all hospitalized COVID-19 patients.
Abstract

Keywords:
Arterial thromboembolismCOVID-19Meta-analysisVenous thromboembolism

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