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Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis
BACKGROUND: Venous thromboembolism (VTE) may complicate the course of Coronavirus Disease 2019 (COVID-19). OBJECTIVES: To evaluate the incidence of VTE in patients with COVID-19. METHODS: MEDLINE, EMBASE, and PubMed were searched up to 24th June 2020 for studies that evaluated the incidence of VTE,...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Ltd.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7420982/ https://www.ncbi.nlm.nih.gov/pubmed/32853978 http://dx.doi.org/10.1016/j.thromres.2020.08.020 |
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author | Porfidia, Angelo Valeriani, Emanuele Pola, Roberto Porreca, Ettore Rutjes, Anne W.S. Di Nisio, Marcello |
author_facet | Porfidia, Angelo Valeriani, Emanuele Pola, Roberto Porreca, Ettore Rutjes, Anne W.S. Di Nisio, Marcello |
author_sort | Porfidia, Angelo |
collection | PubMed |
description | BACKGROUND: Venous thromboembolism (VTE) may complicate the course of Coronavirus Disease 2019 (COVID-19). OBJECTIVES: To evaluate the incidence of VTE in patients with COVID-19. METHODS: MEDLINE, EMBASE, and PubMed were searched up to 24th June 2020 for studies that evaluated the incidence of VTE, including pulmonary embolism (PE) and/or deep vein thrombosis (DVT), in patients with COVID-19. Pooled proportions with corresponding 95% confidence intervals (CI) and prediction intervals (PI) were calculated by random-effect meta-analysis. RESULTS: 3487 patients from 30 studies were included. Based on very low-quality evidence due to heterogeneity and risk of bias, the incidence of VTE was 26% (95% PI, 6%–66%). PE with or without DVT occurred in 12% of patients (95% PI, 2%–46%) and DVT alone in 14% (95% PI, 1%–75%). Studies using standard algorithms for clinically suspected VTE reported PE in 13% of patients (95% PI, 2%–57%) and DVT in 6% (95% PI, 0%–60%), compared to 11% (95% PI, 2%–46%) and 24% (95% PI, 2%–85%) in studies using other diagnostic strategies or patient sampling. In patients admitted to intensive care units, VTE occurred in 24% (95% PI, 5%–66%), PE in 19% (95% PI, 6%–47%), and DVT alone in 7% (95% PI, 0%–69%). Corresponding values in general wards were respectively 9% (95% PI, 0%–94%), 4% (95% PI, 0%–100%), and 7% (95% CI, 1%–49%). CONCLUSIONS: VTE represents a frequent complication in hospitalized COVID-19 patients and often occurs as PE. The threshold for clinical suspicion should be low to trigger prompt diagnostic testing. |
format | Online Article Text |
id | pubmed-7420982 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74209822020-08-12 Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis Porfidia, Angelo Valeriani, Emanuele Pola, Roberto Porreca, Ettore Rutjes, Anne W.S. Di Nisio, Marcello Thromb Res Full Length Article BACKGROUND: Venous thromboembolism (VTE) may complicate the course of Coronavirus Disease 2019 (COVID-19). OBJECTIVES: To evaluate the incidence of VTE in patients with COVID-19. METHODS: MEDLINE, EMBASE, and PubMed were searched up to 24th June 2020 for studies that evaluated the incidence of VTE, including pulmonary embolism (PE) and/or deep vein thrombosis (DVT), in patients with COVID-19. Pooled proportions with corresponding 95% confidence intervals (CI) and prediction intervals (PI) were calculated by random-effect meta-analysis. RESULTS: 3487 patients from 30 studies were included. Based on very low-quality evidence due to heterogeneity and risk of bias, the incidence of VTE was 26% (95% PI, 6%–66%). PE with or without DVT occurred in 12% of patients (95% PI, 2%–46%) and DVT alone in 14% (95% PI, 1%–75%). Studies using standard algorithms for clinically suspected VTE reported PE in 13% of patients (95% PI, 2%–57%) and DVT in 6% (95% PI, 0%–60%), compared to 11% (95% PI, 2%–46%) and 24% (95% PI, 2%–85%) in studies using other diagnostic strategies or patient sampling. In patients admitted to intensive care units, VTE occurred in 24% (95% PI, 5%–66%), PE in 19% (95% PI, 6%–47%), and DVT alone in 7% (95% PI, 0%–69%). Corresponding values in general wards were respectively 9% (95% PI, 0%–94%), 4% (95% PI, 0%–100%), and 7% (95% CI, 1%–49%). CONCLUSIONS: VTE represents a frequent complication in hospitalized COVID-19 patients and often occurs as PE. The threshold for clinical suspicion should be low to trigger prompt diagnostic testing. Elsevier Ltd. 2020-12 2020-08-12 /pmc/articles/PMC7420982/ /pubmed/32853978 http://dx.doi.org/10.1016/j.thromres.2020.08.020 Text en © 2020 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Full Length Article Porfidia, Angelo Valeriani, Emanuele Pola, Roberto Porreca, Ettore Rutjes, Anne W.S. Di Nisio, Marcello Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis |
title | Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis |
title_full | Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis |
title_fullStr | Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis |
title_full_unstemmed | Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis |
title_short | Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis |
title_sort | venous thromboembolism in patients with covid-19: systematic review and meta-analysis |
topic | Full Length Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7420982/ https://www.ncbi.nlm.nih.gov/pubmed/32853978 http://dx.doi.org/10.1016/j.thromres.2020.08.020 |
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