Proximal deep vein thrombosis and pulmonary embolism in COVID-19 patients: a systematic review and meta-analysis.
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9 mars 2021
- doi: 10.1186/s12959-021-00266-x
- issn: 1477-9560
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info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_727047BE71174
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Reviews Reviews Reviews Theater reviews Mechanical properties testing Reviews Television plays--Reviews Television reviews Natural science Sciences Science of science Reviews Newspapers--Sections, columns, etc.--Book section Pelvic limbs Lower limb Extremities, Lower Pelvic limb Limb, Lower Extremity, Lower Legs Limb, Pelvic Lower extremities Lower extremity Lower limbs Controlled clinical trials Randomized clinical trials Trials, Clinical Patient trials of new treatments Book reviews Reviews Use of Methods of analysis Analysis and chemistry Analytical methods Chemical analysis Analysis methods Analysis and examination illnessCiter ce document
G. Longchamp et al., « Proximal deep vein thrombosis and pulmonary embolism in COVID-19 patients: a systematic review and meta-analysis. », Serveur académique Lausannois, ID : 10.1186/s12959-021-00266-x
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COVID-19 appears to be associated with a high risk of venous thromboembolism (VTE). We aimed to systematically review and meta-analyze the risk of clinically relevant VTE in patients hospitalized for COVID-19. This meta-analysis included original articles in English published from January 1st, 2020 to June 15th, 2020 in Pubmed/MEDLINE, Embase, Web of science, and Cochrane. Outcomes were major VTE, defined as any objectively diagnosed pulmonary embolism (PE) and/or proximal deep vein thrombosis (DVT). Primary analysis estimated the risk of VTE, stratified by acutely and critically ill inpatients. Secondary analyses explored the separate risk of proximal DVT and of PE; the risk of major VTE stratified by screening and by type of anticoagulation. In 33 studies (n = 4009 inpatients) with heterogeneous thrombotic risk factors, VTE incidence was 9% (95%CI 5-13%, I 2 = 92.5) overall, and 21% (95%CI 14-28%, I 2 = 87.6%) for patients hospitalized in the ICU. Proximal lower limb DVT incidence was 3% (95%CI 1-5%, I 2 = 87.0%) and 8% (95%CI 3-14%, I 2 = 87.6%), respectively. PE incidence was 8% (95%CI 4-13%, I 2 = 92.1%) and 17% (95%CI 11-25%, I 2 = 89.3%), respectively. Screening and absence of anticoagulation were associated with a higher VTE incidence. When restricting to medically ill inpatients, the VTE incidence was 2% (95%CI 0-6%). The risk of major VTE among COVID-19 inpatients is high but varies greatly with severity of the disease. These findings reinforce the need for the use of thromboprophylaxis in all COVID-19 inpatients and for clinical trials testing different thromboprophylaxis regimens in subgroups of COVID-19 inpatients. The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews ( CRD42020193369 ).