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. 2021 Apr 29:8:603558.
doi: 10.3389/fmed.2021.603558. eCollection 2021.

Prevalence of Venous Thromboembolism in Critically Ill Patients With Coronavirus Disease 2019: A Meta-Analysis

Changgang Wu  1 , Yunlong Liu  2 , Xiangjing Cai  1 , Wenming Zhang  3 , Yongjie Li  1 , Chunsheng Fu  2
Affiliations

Prevalence of Venous Thromboembolism in Critically Ill Patients With Coronavirus Disease 2019: A Meta-Analysis

Changgang Wu et al. Front Med (Lausanne). .

Abstract

Background: Accumulating evidence suggests that coronavirus disease 2019 (COVID-19) is associated with hypercoagulative status, particularly for critically ill patients in the intensive care unit. However, the prevalence of venous thromboembolism (VTE) in these patients under routine prophylactic anticoagulation remains unknown. A meta-analysis was performed to evaluate the prevalence of VTE in these patients by pooling the results of these observational studies. Methods: Observational studies that reported the prevalence of VTE in critically ill patients with COVID-19 were identified by searching the PubMed and Embase databases. A random-effect model was used to pool the results by incorporating the potential heterogeneity. Results: A total of 19 studies with 1,599 patients were included. The pooled results revealed that the prevalence of VTE, deep venous thrombosis (DVT), and pulmonary embolism (PE) in critically ill patients with COVID-19 was 28.4% [95% confidence interval (CI): 20.0-36.8%], 25.6% (95% CI: 17.8-33.4%), and 16.4% (95% CI: 10.1-22.7%), respectively. Limited to studies, in which all patients received routine prophylactic anticoagulation, and the prevalence for VTE, DVT, and PE was 30.1% (95% CI: 19.4-40.8%), 27.2% (95% CI: 16.5-37.9%), and 18.3% (95% CI: 9.8%-26.7%), respectively. The prevalence of DVT was higher in studies with routine screening for all patients, when compared to studies with screening only in clinically suspected patients (47.5% vs. 15.1%, P < 0.001). Conclusion: Critically ill patients with COVID-19 have a high prevalence of VTE, despite the use of present routine prophylactic anticoagulation.

Keywords: coronavirus disease 2019; critically ill; meta-analysis; prevalence; venous thromboembolism.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart for the literature search.
Figure 2
Figure 2
Forest plots for the meta-analysis of the prevalence of VTE in critically ill patients with COVID-19 stratified by the status of prophylaxis.
Figure 3
Figure 3
Forest plots for the meta-analysis of the prevalence of DVT in critically ill patients with COVID-19: (A) stratified by the status of the prophylaxis; (B) stratified by the screening strategy.
Figure 4
Figure 4
Forest plots for the meta-analysis of the prevalence of PE in critically ill patients with COVID-19 stratified by the status of prophylaxis.
See this image and copyright information in PMC

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