A meta-analysis to estimate the incidence of thromboembolism in hospitalized COVID-19 patients

Ayema Haque; Areeba Minhaj; Areeba Ahmed; Owais Khan; Palvisha Qasim; Hasan Fareed; Fatima Nazir; Ayesha Asghar; Kashif Ali; Sobia Mansoor; Ayema Haque; Areeba Minhaj; Areeba Ahmed; Owais Khan; Palvisha Qasim; Hasan Fareed; Fatima Nazir; Ayesha Asghar; Kashif Ali; Sobia Mansoor

doi:10.3934/medsci.2020020

AIMS Medical Science

2020, Volume 7, Issue 4: 301-310. doi: 10.3934/medsci.2020020

Previous Article Next Article

Research article

A meta-analysis to estimate the incidence of thromboembolism in hospitalized COVID-19 patients

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan

Received: 06 September 2020 Accepted: 12 November 2020 Published: 19 November 2020

Coronavirus disease 2019 (COVID-19) is associated with an increased risk of venous and arterial thrombosis in patients. Numerous studies have been conducted on COVID-19 and its association with thromboembolism is well known. We conducted a meta-analysis to find out the incidence of thromboembolism in hospitalised patients with COVID-19 to provide more generalized results. A systematic literature search was conducted in PubMed and SCOPUS to find observational studies reporting outcomes of interest. Amongst the studied thromboembolic events, the meta-analysis showed the prevalence of pulmonary embolism (PP: 12.4% [7.2%, 18.6%]; I2 = 97.23%) to be the highest. It was followed by deep vein thrombosis (PP: 8.6% [4.2%, 14.3%]; I2 = 97.52%), myocardial infarction (PP: 2.3% [0.2%, 11.2%]; I2 = 99.3%), and stroke (PP: 1.2% [0.8%, 1.6%]; I2 = 65.09%). The results of this analysis further warrant the timely and appropriate use of pharmacological thromboprophylaxis and identification of risk factors in hospitalized COVID-19 patients.
- COVID-19,
- SARS-CoV-2,
- thromboembolism,
- meta-analysis,
- pulmonary embolism,
- stroke,
- myocardial infarction,
- deep venous thrombosis
Citation: Ayema Haque, Areeba Minhaj, Areeba Ahmed, Owais Khan, Palvisha Qasim, Hasan Fareed, Fatima Nazir, Ayesha Asghar, Kashif Ali, Sobia Mansoor. A meta-analysis to estimate the incidence of thromboembolism in hospitalized COVID-19 patients[J]. AIMS Medical Science, 2020, 7(4): 301-310. doi: 10.3934/medsci.2020020

Related Papers:

Abstract

Coronavirus disease 2019 (COVID-19) is associated with an increased risk of venous and arterial thrombosis in patients. Numerous studies have been conducted on COVID-19 and its association with thromboembolism is well known. We conducted a meta-analysis to find out the incidence of thromboembolism in hospitalised patients with COVID-19 to provide more generalized results. A systematic literature search was conducted in PubMed and SCOPUS to find observational studies reporting outcomes of interest. Amongst the studied thromboembolic events, the meta-analysis showed the prevalence of pulmonary embolism (PP: 12.4% [7.2%, 18.6%]; I2 = 97.23%) to be the highest. It was followed by deep vein thrombosis (PP: 8.6% [4.2%, 14.3%]; I2 = 97.52%), myocardial infarction (PP: 2.3% [0.2%, 11.2%]; I2 = 99.3%), and stroke (PP: 1.2% [0.8%, 1.6%]; I2 = 65.09%). The results of this analysis further warrant the timely and appropriate use of pharmacological thromboprophylaxis and identification of risk factors in hospitalized COVID-19 patients.

Conflict of interest

The authors declare no conflict of interest.

References

[1]	Bikdeli B, Madhavan MV, Jimenez D, et al. (2020) COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. J Am Coll Cardiol 75: 2950-2973. doi: 10.1016/j.jacc.2020.04.031
[2]	Connors JM, Levy JH (2020) COVID-19 and its implications for thrombosis and anticoagulation. Blood J Am Soci Hematol 135: 2033-2040.
[3]	Liberati A, Altman DG, Tetzlaff J, et al. (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151: W65-94. doi: 10.7326/0003-4819-151-4-200908180-00136
[4]	Angeli F, Spanevello A, De Ponti, et al. (2020) Electrocardiographic features of patients with COVID-19 pneumonia. Eur J Intern Med 78: 101-106. doi: 10.1016/j.ejim.2020.06.015
[5]	Bilaloglu S, Aphinyanaphongs Y, Jones S, et al. (2020) Thrombosis in hospitalized patients with COVID-19 in a New York City health system. JAMA 324: 799-801. doi: 10.1001/jama.2020.13372
[6]	Bompard F, Monnier H, Saab I, et al. (2020) Pulmonary embolism in patients with Covid-19 pneumonia. Eur Respir J 56: 2001365. doi: 10.1183/13993003.01365-2020
[7]	Cantador E, Núñez A, Sobrino P, et al. (2020) Incidence and consequences of systemic arterial thrombotic events in COVID-19 patients. J Thromb Thrombolysis 50: 543-547. doi: 10.1007/s11239-020-02176-7
[8]	Demelo-Rodríguez P, Cervilla-Muñoz E, Ordieres-Ortega L, et al. (2020) Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels. Thromb Res 192: 23-26. doi: 10.1016/j.thromres.2020.05.018
[9]	Helms J, Tacquard C, Severac F, et al. (2020) High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med 46: 1089-1098. doi: 10.1007/s00134-020-06062-x
[10]	Jain R, Young M, Dogra S, et al. (2020) COVID-19 related neuroimaging findings: a signal of thromboembolic complications and a strong prognostic marker of poor patient outcome. J Neurol Sci 414: 116923. doi: 10.1016/j.jns.2020.116923
[11]	Klok F, Kruip M, Van der Meer N, et al. (2020) Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 191: 145-147. doi: 10.1016/j.thromres.2020.04.013
[12]	Llitjos JF, Leclerc M, Chochois C, et al. (2020) High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. J Thromb Haemost 18: 1743-1746. doi: 10.1111/jth.14869
[13]	Lodigiani C, Iapichino G, Carenzo L, et al. (2020) Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res 191: 9-14. doi: 10.1016/j.thromres.2020.04.024
[14]	Middeldorp S, Coppens M, van Haaps TF, et al. (2020) Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost 18: 1995-2002. doi: 10.1111/jth.14888
[15]	Poyiadji N, Cormier P, Patel PY, et al. (2020) Acute pulmonary embolism and COVID-19. Radiology 201955.
[16]	Yaghi S, Ishida K, Torres J, et al. (2020) SARS2-CoV-2 and stroke in a New York healthcare system. Stroke 51.
[17]	Zhang L, Feng X, Zhang D, et al. (2020) Deep vein thrombosis in hospitalized patients with coronavirus disease 2019 (COVID-19) in Wuhan, China: prevalence, risk factors, and outcome. Circulation 142.
[18]	Bi Q, Hong C, Meng J, et al. (2020) Characterizing clinical progression of COVID-19 among patients in Shenzhen, China: an observational cohort study. medRxiv .
[19]	Cui S, Chen S, Li X, et al. (2020) Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost 18: 1421-1424. doi: 10.1111/jth.14830
[20]	Grillet F, Behr J, Calame P, et al. (2020) Acute pulmonary embolism associated with COVID-19 pneumonia detected with pulmonary CT angiography. Radiology 296: E186-E188. doi: 10.1148/radiol.2020201544
[21]	Léonard-Lorant I, Delabranche X, Séverac F, et al. (2020) Acute pulmonary embolism in patients with COVID-19 at CT angiography and relationship to d-Dimer levels. Radiology 296: E189-E191. doi: 10.1148/radiol.2020201561
[22]	Li T, Kicska G, Kinahan PE, et al. (2020) Clinical and imaging findings in COVID-19 patients complicated by pulmonary embolism. medRxiv .
[23]	Poissy J, Goutay J, Caplan M, et al. (2020) Pulmonary embolism in patients with COVID-19. Circulation 142: 184-186. doi: 10.1161/CIRCULATIONAHA.120.047430
[24]	Al-Ani F, Chehade S, Lazo-Langner A (2020) Thrombosis risk associated with COVID-19 infection. A scoping review. Thromb Res 192: 152-160. doi: 10.1016/j.thromres.2020.05.039
[25]	Klok FA, Kruip M, Van Der Meer N, et al. (2020) Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thromb Res 191: 148-150. doi: 10.1016/j.thromres.2020.04.041
[26]	Fritz MK, Kincaid SE, Sargent CG, et al. (2020) Venous thromboembolism (VTE) risk stratification in general medical patients at an academic medical center. J Thromb Thrombolysis in press.
[27]	Stein PD, Beemath A, Olson RE (2005) Trends in the incidence of pulmonary embolism and deep venous thrombosis in hospitalized patients. Am J Cardiol 95: 1525-1526. doi: 10.1016/j.amjcard.2005.02.030
[28]	Wichmann D, Sperhake JP, Lütgehetmann M, et al. (2020) Autopsy findings and venous thromboembolism in patients with COVID-19: a prospective cohort study. Ann Intern Med 173: 268-277. doi: 10.7326/M20-2003
[29]	Tang N, Bai H, Chen X, et al. (2020) Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 18: 1094-1099. doi: 10.1111/jth.14817
[30]	Jose RJ, Manuel A (2020) COVID-19 cytokine storm: the interplay between inflammation and coagulation. Lancet Respir Med 8: e46-e47. doi: 10.1016/S2213-2600(20)30216-2
[31]	Kwong JC, Schwartz KL, Campitelli MA, et al. (2018) Acute myocardial infarction after laboratory-confirmed influenza infection. N Engl J Med 378: 345-353. doi: 10.1056/NEJMoa1702090
[32]	Stefanini GG, Montorfano M, Trabattoni D, et al. (2020) ST-Elevation myocardial infarction in patients with COVID-19: clinical and angiographic outcomes. Circulation 141: 2113-2116. doi: 10.1161/CIRCULATIONAHA.120.047525
[33]	Gavioli, Elizabeth M, Sikorska G, et al. (2020) Current perspectives of anticoagulation in patients with COVID-19. J Cardiovasc Pharmacol 76: 146-150.
[34]	Fifi JT, Mocco J (2020) COVID-19 related stroke in young individuals. Lancet Neurol 19: 713-715. doi: 10.1016/S1474-4422(20)30272-6
[35]	Merkler AE, Parikh NS, Mir S, et al. (2020) Risk of ischemic stroke in patients with Covid-19 versus patients with influenza. medRxiv .

Reader Comments

Your name:*

Email:*
© 2020 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)