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COVID and venous thrombosis: systematic review of literature

Daniela Mazzaccaro1, Matteo Giannetta2, Fabiana Fancoli2

  • 1Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy - daniela.mazzaccaro@gmail.com.

The Journal of Cardiovascular Surgery
|September 14, 2021
PubMed

Insights

Venous thrombosis (VT) is common in hospitalized COVID-19 patients, especially in ICUs. Risk factors include older age, obesity, and high D-dimer levels, while female sex appears protective.

Area of Science:

  • Medical Research
  • Infectious Diseases
  • Cardiovascular Health

Background:

  • COVID-19 (Coronavirus Disease 19) has been associated with an increased risk of thrombotic events.
  • Understanding the prevalence and risk factors for venous thrombosis (VT) in hospitalized COVID-19 patients is crucial for clinical management.

Purpose of the Study:

  • To systematically review the prevalence, risk factors, and outcomes of venous thrombosis (VT) in patients hospitalized with COVID-19.
  • To synthesize current evidence on the incidence and clinical characteristics of VT in this population.

Main Methods:

  • A comprehensive literature search was conducted using terms related to "COVID venous thrombosis" in electronic bibliographic databases.
  • The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  • Data from 69 papers (qualitative) and 23 papers (quantitative) involving 106,838 patients were analyzed.

Main Results:

  • The pooled prevalence of VT among hospitalized COVID-19 patients was a median of 16.7%, significantly higher in intensive care unit (ICU) patients (60.8-85.4%).
  • VT most commonly affected distal veins of the lower limb (popliteal and calf veins) and was asymptomatic in 6.1% of cases.
  • Increased odds of VT were associated with older age (OR=3.54), higher D-dimer levels (OR=956.86), and obesity (OR=1.42). Female sex showed a protective effect (OR=0.77).

Conclusions:

  • Venous thrombosis is a frequent complication in hospitalized COVID-19 patients, particularly those in the ICU.
  • Distal lower limb veins are the primary sites for VT, often presenting without symptoms.
  • Older age, obesity, and elevated D-dimer levels are significant risk factors for VT in COVID-19 patients.
Abstract

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