Clinical Characteristics and Outcomes of Venous Thromboembolism in Patients Hospitalized for COVID-19: Systematic Review and Meta-Analysis
Abstract
Objective
To investigate the clinical characteristics and outcomes of Coronavirus Disease of 2019 (COVID-19) patients complicated with venous thromboembolism (VTE)
Method
We performed a comprehensive literature search of several databases to find studies that assessed VTE in hospitalized COVID-19 patients with a primary outcome of all-cause mortality and secondary outcomes of intensive care unit (ICU) admission and mechanical ventilation. We also evaluated the clinical characteristics of VTE sufferers.
Results
Eight studies have been included with a total of 1237 pooled subjects. Venous thromboembolism was associated with higher mortality (RR 2.48 (1.35, 4.55),p=0.003;I25%,p=0.35) after we performed sensitivity analysis, ICU admission (RR 2.32 (1.53, 3.52),p<0.0001;I280%,p<0.0001), and mechanical ventilation need (RR 2.73 (1.56, 4.78),p=0.0004;I277%,p=0.001). Furthermore, it was also associated to male gender (RR 1.21 (1.08, 1.35),p=0.0007;I212%,p=0.34), higher white blood cells count (MD 1.24 (0.08, 2.41), 0.04;I20%; 0.26), D-dimer (MD 4.49 (2.74, 6.25),p<0.00001;I267%,p=0.009) and LDH levels (MD 70.93 (19.33, 122.54),p<0.007;I221%, p=0.28). In addition, after sensitivity analysis was conducted, VTE also associated with older age (MD 2.79 (0.06, 5.53),p=0.05;I225%,p=0.24) and higher CRP levels (MD 2.57 (0.88, 4.26);p=0.003;I20%,p=0.96).
Conclusion
Venous thromboembolism in COVID-19 patients was associated with increased mortality, ICU admission, and mechanical ventilation requirement. Male gender, older age, higher levels of biomarkers, including WBC count, D-Dimer, and LDH were also being considerably risks for developing VTE in COVID-19 patients during hospitalization.
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