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Meta-Analysis
. 2020 Jan-Dec:26:1076029620967083.
doi: 10.1177/1076029620967083.

Prevalence and Risk Factors of Thromboembolism among Patients With Coronavirus Disease-19: A Systematic Review and Meta-Analysis

Belayneh Kefale  1 , Gobezie T Tegegne  2 , Amsalu Degu  3 , Melaku Tadege  4 , Desalegn Tesfa  4
Affiliations
Meta-Analysis

Prevalence and Risk Factors of Thromboembolism among Patients With Coronavirus Disease-19: A Systematic Review and Meta-Analysis

Belayneh Kefale et al. Clin Appl Thromb Hemost. 2020 Jan-Dec.

Abstract

Emerging evidence shows that the recent pandemic of coronavirus disease 19 (COVID-19) is characterized by coagulation activation and endothelial dysfunction. This increases the risk of morbidity, mortality and economic loss among COVID-19 patients. Therefore, there was an urgent need to investigate the extent and risk factors of thromboembolism among COVID-19 patients. English-language based databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Cochrane library) were exhaustively searched to identify studies related to prevalence of thromboembolism among hospitalized COVID-19 patients. A random-effects model was employed to estimate the pooled prevalence of thromboembolism. The pooled prevalence of thrombotic events was computed using STATA 16.0 software. Heterogeneity analysis was reported using I2. A total of 19 studies with 2,520 patients with COVID-19 were included. The pooled prevalence of thrombotic events of hospitalized patients with COVID-19 was 33% (95% CI: 25-41%, I2 = 97.30%, p < 0.001) with a high degree of heterogeneity across studies. Elevated D-dimer hospitalized in the intensive care unit and being under mechanical ventilation were the most frequently associated factors for the development of thrombotic events. The pooled prevalence of thrombotic events in COVID-19 patients was 33%. The prevalence of thrombotic event is variables on the basis of study design and study centers. Several risk factors such as, elevated D-dimer, hospitalized in the intensive care unit and being under mechanical ventilation, were the most frequently reported risk factors identified. Therefore, healthcare professionals should consider these risk factors to optimally manage thromboembolism in COVID-19 patients.

Keywords: COVID-19; prevalence; risk factors; thromboembolism.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow chart showing article-screening process.
Figure 2.
Figure 2.
Forest plot illustrating the pooled analysis of 19 studies reporting thrombotic events in patients with COVID-19.
Figure 3.
Figure 3.
Subgroup analysis of thrombotic event by patient characteristics.
Figure 4.
Figure 4.
Subgroup analysis of thrombotic events based on study design.
Figure 5.
Figure 5.
Subgroup analysis of studies reporting the prevalence of thrombotic event segregated by country.
Figure 6.
Figure 6.
Subgroup analysis of studies describing the prevalence of thrombotic event by number of settings.
Figure 7.
Figure 7.
Publication bias using funnel plot of standard error by Logit event rate.
See this image and copyright information in PMC

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