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. 2020 Nov 23;18(1):34.
doi: 10.1186/s12959-020-00248-5.

Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis

Kochawan Boonyawat  1 , Pichika Chantrathammachart  2 , Pawin Numthavaj  3 , Nithita Nanthatanti  4 , Sithakom Phusanti  4 , Angsana Phuphuakrat  2 , Pimjai Niparuck  2 , Pantep Angchaisuksiri  2
Affiliations

Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis

Kochawan Boonyawat et al. Thromb J. .

Erratum in

Abstract

Background: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the incidence of thromboembolism has been increasingly reported. The aim of this systematic review was to explore the incidence of venous and arterial thromboembolism among COVID-19 patients requiring hospitalization.

Methods: Medline, Embase, Scopus, and grey literature were searched until June 2020. Observational studies reported on the incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT) or arterial thromboembolism (ATE) were included. The pool incidences and their 95% confidence intervals (CI) were calculated using the random-effects model.

Results: A total of 36 studies were included. In the intensive care unit (ICU) setting, the pooled incidence of VTE was 28% (95% CI, 22-34%). Subgroups based on compression ultrasound (CUS) screening revealed a higher incidence of DVT in the CUS screening group than in the no CUS screening group (32% [95% CI, 18-45%] vs. 6% [95% CI, 4-9%]). The pooled incidence of ATE in ICU was 3% (95% CI, 2-5%). In the non-ICU setting, the pooled incidence of VTE was 10% (95% CI, 6-14%,).

Conclusions: The incidence of VTE in COVID-19 patients was higher in the ICU setting than in the non-ICU setting, and also significantly higher in studies that incorporated the CUS screening protocol. The incidence of ATE in the ICU setting was low. VTE prophylactic measures should be given to all hospitalized patients diagnosed with COVID-19.

Keywords: Arterial thromboembolism; COVID-19; Meta-analysis; Venous thromboembolism.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Fig. 1
Fig. 1
The pooled incidence of VTE from clinical studies in the ICU stteing. Forest plot of studies showed the pooled incidence of VTE from clinical studies in the ICU setting. The analysis included 21 clinical studies. VTE occurred in 465 of 1766 patients with COVID-19 admitted in the ICU. P value for heterogeneity was less than 0.001
Fig. 2
Fig. 2
Subgroup analysis of the pooled incidence of DVT from clinical studies in the ICU setting based on CUS screening. Forest plot of subgroup analysis of the incidence of DVT in the ICU setting based on studies with CUS screening. There were 12 studies with no CUS screening and 9 studies with CUS screening. DVT were found in 102 of 1377 patients with no CUS screening and in 121 of 389 patients with CUS screening. P value for heterogeneity between groups was less than 0.001
Fig. 3
Fig. 3
The pooled incidence of VTE from clinical studies in the ICU setting by country. Forest plot of the subgroup analysis of the incidence of VTE in the ICU setting based on countries. Three studies were from the Netherlands where VTE occurred in 130 of 334 patients. Six studies from France where VTE occurred in 212 of 784 patients. Three studies from Italy where VTE occurred in 23 of 145 patients. Three studies from China where VTE occurred in 43 of 162 patients. One study from Belgium where VTE occurred in 4 of 30 patients. Two studies from UK where VTE occurred in 17 of 142 patients. One study from Switzerland where VTE occurred in 8 of 25 patients . One study from USA where VTE occurred in 24 of 107 patients. One study from Germany where VTE occurred in 4 of 40 patients
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