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A meta-analysis of the incidence of venous thromboembolic events and impact of anticoagulation on mortality in patients with COVID-19.
Int J Infect Dis. 2020 Nov; 100:34-41.IJ

Abstract

BACKGROUND

The incidence of venous thromboembolic events (VTE) in patients with COVID-19 is generally high but varies markedly. However, the relationship between anticoagulation and mortality in patients with COVID-19 is still unclear.

METHODS

We performed a systematic review and meta-analysis to determine the incidence of VTE and evaluate the role of anticoagulation in patients with COVID-19. Random effects models were used to determine overall pooled estimates and 95% confidence intervals (CIs).

RESULTS

After a database search, 25 observational studies (20 on VTE incidence and 5 on the relationship between anticoagulation and mortality) were included. The pooled incidence rates of VTE, pulmonary embolism (PE), and deep vein thrombosis (DVT) in hospitalised COVID-19 patients were 21% (95% CI 15-27%), 15% (95% CI 10-20%), and 27% (95% CI 19-36%), respectively. A meta-analysis of five studies found that anticoagulation was not associated with an increased risk of mortality in hospitalised COVID-19 patients (RR = 0.86, 95% CI, 0.69-1.09, P = 0.218; I2 = 47.4%).

CONCLUSIONS

In conclusion, the incidence of VTE among hospitalised COVID-19 patients was high. Clinical trials are urgently needed to evaluate the roles of prophylactic and therapeutic anticoagulation in COVID-19.

Authors+Show Affiliations

Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.Department of Child and Adolescent Psychiatry, Ningbo Kangning Hospital, Ningbo, Zhejiang, China.Department of Child and Adolescent Psychiatry, Ningbo Kangning Hospital, Ningbo, Zhejiang, China.Department of Child and Adolescent Psychiatry, Ningbo Kangning Hospital, Ningbo, Zhejiang, China.Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. Electronic address: 0015413@zju.edu.cn.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32798659

Citation

Lu, Ying-Feng, et al. "A Meta-analysis of the Incidence of Venous Thromboembolic Events and Impact of Anticoagulation On Mortality in Patients With COVID-19." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 100, 2020, pp. 34-41.
Lu YF, Pan LY, Zhang WW, et al. A meta-analysis of the incidence of venous thromboembolic events and impact of anticoagulation on mortality in patients with COVID-19. Int J Infect Dis. 2020;100:34-41.
Lu, Y. F., Pan, L. Y., Zhang, W. W., Cheng, F., Hu, S. S., Zhang, X., & Jiang, H. Y. (2020). A meta-analysis of the incidence of venous thromboembolic events and impact of anticoagulation on mortality in patients with COVID-19. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 100, 34-41. https://doi.org/10.1016/j.ijid.2020.08.023
Lu YF, et al. A Meta-analysis of the Incidence of Venous Thromboembolic Events and Impact of Anticoagulation On Mortality in Patients With COVID-19. Int J Infect Dis. 2020;100:34-41. PubMed PMID: 32798659.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A meta-analysis of the incidence of venous thromboembolic events and impact of anticoagulation on mortality in patients with COVID-19. AU - Lu,Ying-Feng, AU - Pan,Li-Ya, AU - Zhang,Wen-Wu, AU - Cheng,Fang, AU - Hu,Sha-Sha, AU - Zhang,Xue, AU - Jiang,Hai-Yin, Y1 - 2020/08/13/ PY - 2020/06/27/received PY - 2020/07/27/revised PY - 2020/08/09/accepted PY - 2020/8/18/pubmed PY - 2020/12/2/medline PY - 2020/8/18/entrez KW - COVID-19 KW - antithrombotic KW - coagulation KW - heparin SP - 34 EP - 41 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int J Infect Dis VL - 100 N2 - BACKGROUND: The incidence of venous thromboembolic events (VTE) in patients with COVID-19 is generally high but varies markedly. However, the relationship between anticoagulation and mortality in patients with COVID-19 is still unclear. METHODS: We performed a systematic review and meta-analysis to determine the incidence of VTE and evaluate the role of anticoagulation in patients with COVID-19. Random effects models were used to determine overall pooled estimates and 95% confidence intervals (CIs). RESULTS: After a database search, 25 observational studies (20 on VTE incidence and 5 on the relationship between anticoagulation and mortality) were included. The pooled incidence rates of VTE, pulmonary embolism (PE), and deep vein thrombosis (DVT) in hospitalised COVID-19 patients were 21% (95% CI 15-27%), 15% (95% CI 10-20%), and 27% (95% CI 19-36%), respectively. A meta-analysis of five studies found that anticoagulation was not associated with an increased risk of mortality in hospitalised COVID-19 patients (RR = 0.86, 95% CI, 0.69-1.09, P = 0.218; I2 = 47.4%). CONCLUSIONS: In conclusion, the incidence of VTE among hospitalised COVID-19 patients was high. Clinical trials are urgently needed to evaluate the roles of prophylactic and therapeutic anticoagulation in COVID-19. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/32798659/A_meta_analysis_of_the_incidence_of_venous_thromboembolic_events_and_impact_of_anticoagulation_on_mortality_in_patients_with_COVID_19_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(20)30652-4 DB - PRIME DP - Unbound Medicine ER -