Next Article in Journal
Respective Effects of Oral Hygiene Instructions and Periodontal Nonsurgical Treatment (Debridement) on Clinical Parameters and Patient-Reported Outcome Measures with Respect to Smoking
Next Article in Special Issue
Telemedicine-Based Specialized Care Improves the Outcome of Anticoagulated Individuals with Venous Thromboembolism—Results from the thrombEVAL Study
Previous Article in Journal
Psychological Profile and Distinct Salivary Cortisol Awake Response (CAR) in Two Different Study Populations with Obstructive Sleep Apnea (OSA) and Central Serous Chorioretinopathy (CSC)
Previous Article in Special Issue
Prevention of Venous Thromboembolism in 2020 and Beyond
Due to scheduled maintenance work on our core network, there may be short service disruptions on this website between 16:00 and 16:30 CEST on September 25th.
Article

Venous Thromboembolism among Hospitalized Patients with COVID-19 Undergoing Thromboprophylaxis: A Systematic Review and Meta-Analysis

1
Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
2
Baim Institute for Clinical Research, Boston, MA 02215, USA
3
Department of Medicine, OSF Saint Francis Medical Center, Peoria, IL 61637, USA
4
Department of Neurology, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, CA 90095, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(8), 2489; https://doi.org/10.3390/jcm9082489
Received: 11 June 2020 / Revised: 12 July 2020 / Accepted: 27 July 2020 / Published: 3 August 2020
(This article belongs to the Special Issue Venous Thromboembolism — Diagnosis, Prevention and Treatment)
Background: Preliminary evidence indicates that prophylactic-dose thromboprophylaxis may be inadequate to control the increased risk of venous thromboembolism (VTE) in patients hospitalized for coronavirus disease 2019 (COVID-19) infection. Additionally, it remains unclear whether the D-dimer measurement is useful for VTE risk stratification among COVID-19 patients. This study aimed to offer benchmark data on the incidence of VTE and to examine the difference in D-dimer levels among anticoagulated COVID-19 patients with and without VTE incident. Methods: A comprehensive literature review of PubMed from inception to May 2020 was performed for original studies that reported the frequency of VTE and death among COVID-19 patients who received thromboprophylaxis on hospitalization. The endpoints included VTE (a composite of pulmonary embolism (PE) or deep vein thrombosis (DVT)), PE, DVT, and mortality. Results: A total of 11 cohort studies were included. Among hospitalized COVID-19 patients, 23.9% (95% confidence interval (CI), 16.2% to 33.7%; I2 = 93%) developed VTE despite anticoagulation. PE and DVT were detected in 11.6% (95% CI, 7.5% to 17.5%; I2 = 92%) and 11.9% (95% CI, 6.3% to 21.3%; I2 = 93%) of patients, respectively. Patients in the intensive care unit (ICU) had a higher risk for VTE (30.4% )95% CI, 19.6% to 43.9%)) than those in the ward (13.0% (95% CI, 5.9% to 26.3%)). The mortality was estimated at 21.3% (95% CI, 17.0% to 26.4%; I2 = 53%). COVID-19 patients who developed VTE had higher D-dimer levels than those who did not develop VTE (mean difference, 2.05 µg/mL; 95% CI, 0.30 to 3.80 µg/mL; P = 0.02). Conclusions: The heightened and heterogeneous risk of VTE in COVID-19 despite prophylactic anticoagulation calls into research on the pathogenesis of thromboembolic complications and strategy of thromboprophylaxis and risk stratification. Prominent elevation of D-dimer may be associated with VTE development and can be used to identify high-risk subsets. View Full-Text
Keywords: venous thromboembolism; pulmonary embolism; deep vein thrombosis; thromboprophylaxis; COVID-19 venous thromboembolism; pulmonary embolism; deep vein thrombosis; thromboprophylaxis; COVID-19
Show Figures

Figure 1

MDPI and ACS Style

Chi, G.; Lee, J.J.; Jamil, A.; Gunnam, V.; Najafi, H.; Memar Montazerin, S.; Shojaei, F.; Marszalek, J. Venous Thromboembolism among Hospitalized Patients with COVID-19 Undergoing Thromboprophylaxis: A Systematic Review and Meta-Analysis. J. Clin. Med. 2020, 9, 2489. https://doi.org/10.3390/jcm9082489

AMA Style

Chi G, Lee JJ, Jamil A, Gunnam V, Najafi H, Memar Montazerin S, Shojaei F, Marszalek J. Venous Thromboembolism among Hospitalized Patients with COVID-19 Undergoing Thromboprophylaxis: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2020; 9(8):2489. https://doi.org/10.3390/jcm9082489

Chicago/Turabian Style

Chi, Gerald, Jane J. Lee, Adeel Jamil, Vamsikrishna Gunnam, Homa Najafi, Sahar Memar Montazerin, Fahimehalsadat Shojaei, and Jolanta Marszalek. 2020. "Venous Thromboembolism among Hospitalized Patients with COVID-19 Undergoing Thromboprophylaxis: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 9, no. 8: 2489. https://doi.org/10.3390/jcm9082489

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop