Venous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis

Background: A high incidence of venous thromboembolism (VTE) is reported in hospitalized COVID-19 patients, in particular in patients admitted to the intensive care unit (ICU). In patients with respiratory tract infections, including influenza A (H1N1), many studies have demonstrated an increased in...

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Autores principales:	Antonella Tufano, Domenico Rendina, Veronica Abate, Aniello Casoria, Annachiara Marra, Pasquale Buonanno, Ferruccio Galletti, Giovanni Di Minno, Giuseppe Servillo, Maria Vargas
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 venous thromboembolism risk difference pulmonary embolism influenza Medicine R
Acceso en línea:	https://doaj.org/article/8a59092872cb48fba37d6650e646a75b
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spelling	oai:doaj.org-article:8a59092872cb48fba37d6650e646a75b2021-11-11T17:33:50ZVenous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis10.3390/jcm102149252077-0383https://doaj.org/article/8a59092872cb48fba37d6650e646a75b2021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4925https://doaj.org/toc/2077-0383Background: A high incidence of venous thromboembolism (VTE) is reported in hospitalized COVID-19 patients, in particular in patients admitted to the intensive care unit (ICU). In patients with respiratory tract infections, including influenza A (H1N1), many studies have demonstrated an increased incidence of thromboses, but evidence is lacking regarding the risk difference (RD) of the occurrence of VTE between COVID-19 and non-COVID-19 patients. Methods: In this systematic review with meta-analysis, we evaluated the RD of the occurrence of VTE, pulmonary embolism (PE), and deep venous thrombosis (DVT) between COVID-19 and other pulmonary infection cohorts, in particular H1N1, and in an ICU setting. We searched for all studies comparing COVID-19 vs. non-COVID-19 regarding VTE, PE, and DVT. Results: The systematic review included 12 studies and 1,013,495 patients. The RD for VTE in COVID-19 compared to non-COVID-19 patients was 0.06 (95% CI 0.11–0.25, <i>p</i> = 0.011, I<sup>2</sup> = 97%), and 0.16 in ICU (95% CI 0.045–0.27, <i>p</i> = 0.006, I<sup>2</sup> = 80%). The RD for PE between COVID-19 and non-COVID-19 patients was 0.03 (95% CI, 0.006–0.045, <i>p</i> = 0.01, I<sup>2</sup> = 89%). The RD for PE between COVID-19 and non-COVID-19 patients was 0.021 in retrospective studies (95% CI 0.00–0.04, <i>p</i> = 0.048, I<sup>2</sup> = 92%) and 0.11 in ICU studies (95% CI 0.06–0.16, <i>p</i> < 0.001, I<sup>2</sup> = 0%). Conclusions: The growing awareness and understanding of a massive inflammatory response combined with a hypercoagulable state that predisposes patients to thrombosis in COVID-19, in particular in the ICU, may contribute to a more appropriate strategy of prevention and earlier detection of the thrombotic events.Antonella TufanoDomenico RendinaVeronica AbateAniello CasoriaAnnachiara MarraPasquale BuonannoFerruccio GallettiGiovanni Di MinnoGiuseppe ServilloMaria VargasMDPI AGarticleCOVID-19venous thromboembolismrisk differencepulmonary embolisminfluenzaMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4925, p 4925 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 venous thromboembolism risk difference pulmonary embolism influenza Medicine R
spellingShingle	COVID-19 venous thromboembolism risk difference pulmonary embolism influenza Medicine R Antonella Tufano Domenico Rendina Veronica Abate Aniello Casoria Annachiara Marra Pasquale Buonanno Ferruccio Galletti Giovanni Di Minno Giuseppe Servillo Maria Vargas Venous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis
description	Background: A high incidence of venous thromboembolism (VTE) is reported in hospitalized COVID-19 patients, in particular in patients admitted to the intensive care unit (ICU). In patients with respiratory tract infections, including influenza A (H1N1), many studies have demonstrated an increased incidence of thromboses, but evidence is lacking regarding the risk difference (RD) of the occurrence of VTE between COVID-19 and non-COVID-19 patients. Methods: In this systematic review with meta-analysis, we evaluated the RD of the occurrence of VTE, pulmonary embolism (PE), and deep venous thrombosis (DVT) between COVID-19 and other pulmonary infection cohorts, in particular H1N1, and in an ICU setting. We searched for all studies comparing COVID-19 vs. non-COVID-19 regarding VTE, PE, and DVT. Results: The systematic review included 12 studies and 1,013,495 patients. The RD for VTE in COVID-19 compared to non-COVID-19 patients was 0.06 (95% CI 0.11–0.25, <i>p</i> = 0.011, I<sup>2</sup> = 97%), and 0.16 in ICU (95% CI 0.045–0.27, <i>p</i> = 0.006, I<sup>2</sup> = 80%). The RD for PE between COVID-19 and non-COVID-19 patients was 0.03 (95% CI, 0.006–0.045, <i>p</i> = 0.01, I<sup>2</sup> = 89%). The RD for PE between COVID-19 and non-COVID-19 patients was 0.021 in retrospective studies (95% CI 0.00–0.04, <i>p</i> = 0.048, I<sup>2</sup> = 92%) and 0.11 in ICU studies (95% CI 0.06–0.16, <i>p</i> < 0.001, I<sup>2</sup> = 0%). Conclusions: The growing awareness and understanding of a massive inflammatory response combined with a hypercoagulable state that predisposes patients to thrombosis in COVID-19, in particular in the ICU, may contribute to a more appropriate strategy of prevention and earlier detection of the thrombotic events.
format	article
author	Antonella Tufano Domenico Rendina Veronica Abate Aniello Casoria Annachiara Marra Pasquale Buonanno Ferruccio Galletti Giovanni Di Minno Giuseppe Servillo Maria Vargas
author_facet	Antonella Tufano Domenico Rendina Veronica Abate Aniello Casoria Annachiara Marra Pasquale Buonanno Ferruccio Galletti Giovanni Di Minno Giuseppe Servillo Maria Vargas
author_sort	Antonella Tufano
title	Venous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis
title_short	Venous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis
title_full	Venous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis
title_fullStr	Venous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis
title_full_unstemmed	Venous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis
title_sort	venous thromboembolism in covid-19 compared to non-covid-19 cohorts: a systematic review with meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8a59092872cb48fba37d6650e646a75b
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Venous Thromboembolism in COVID-19 Compared to Non-COVID-19 Cohorts: A Systematic Review with Meta-Analysis

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