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Meta-Analysis
. 2021 Aug:139:106882.
doi: 10.1016/j.vph.2021.106882. Epub 2021 Jun 2.

Venous thromboembolism in COVID-19 compared to non-COVID-19 cohorts: A systematic review with meta-analysis

Vicky Mai  1 , Boun Kim Tan  2 , Sabine Mainbourg  3 , François Potus  4 , Michel Cucherat  5 , Jean-Christophe Lega  6 , Steeve Provencher  7
Affiliations
Meta-Analysis

Venous thromboembolism in COVID-19 compared to non-COVID-19 cohorts: A systematic review with meta-analysis

Vicky Mai et al. Vascul Pharmacol. 2021 Aug.

Abstract

Background: Many studies confirmed an association between COVID-19 and venous thromboembolism (VTE). Whether the risk of VTE significantly differed between COVID-19 cohorts and non-COVID-19 cohorts with similar disease severity remains unknown.

Objectives: The aim of this systematic review with meta-analysis was to compare the rate of VTE between COVID-19 and non-COVID-19 cohorts with similar disease severity.

Methods: A systematic literature search (MEDLINE, Embase and Google Scholar) was conducted from January 1, 2020 to March 31, 2021 to identify studies reporting VTE in COVID-19. Relative risks (RR) were estimated for the effect measure with 95% confidence intervals.

Results: Seven studies (41,768 patients) evaluated VTE in COVID-19 cohorts compared to non-COVID-19 cohorts. The overall risk of VTE (RR 1.18; 95%CI 0.79-1.77; p = 0.42; I2 = 54%), pulmonary embolism (RR 1.25; 95%CI 0.77-2.03; p = 0.36; I2 = 52%) and deep venous thrombosis (RR 0.92; 95%CI 0.52-1.65; p = 0.78; I2 = 0%) did not significantly differ between COVID-19 and non-COVID-19 cohorts. However, subgroup analyses suggested an increased risk of VTE amongst CODID-19 versus non COVID-19 cohorts when only patients hospitalized within the intensive care unit (ICU) were considered (RR 3.10; 95%CI 1.54-6.23), which was not observed in cohorts of predominantly non-ICU patients (RR 0.95; 95%CI 0.81-1.11) (Pinteraction = 0.001).

Conclusion: There was no signal for a difference in VTE in COVID-19 cohorts compared to non-COVID-19 cohorts, except for the subgroup of patients hospitalized in the ICU. These results should be viewed as exploratory and further studies are needed to confirm these results.

Keywords: Anticoagulation; COVID-19; Pulmonary embolism; Venous thromboembolism.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

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Graphical abstract
Fig. 1
Fig. 1
Study selection.
Fig. 2
Fig. 2
Forest plot and relative risk (RR) for venous thromboembolism (A), pulmonary embolism only (B) and deep venous thrombosis only (C) in COVID-19 cohorts compared to non-COVID-19 cohorts.
See this image and copyright information in PMC

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