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

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.

CT of Post-Acute Lung Complications of COVID-19

“…Given the evidence of direct invasion of the endothelium by SARS-CoV-2 ( 85 ) as well as the associated hypercoagulable state and increased risk of deep vein thrombosis and pulmonary embolism in acute infection ( 86 ), there is concern that venous thromboembolism (VTE) may play a role in a subset of patients with PASC. The prevalence of VTE in hospitalized acute COVID-19 patients may be as high as 25% ( 87 , 88 ) and one study found the rate of pulmonary embolism to be 24% for patients on the general wards and 49% for patients in the ICU ( 89 ). A meta-analysis of 3342 patients showed that pulmonary embolism and deep venous thrombosis occurred in 16.5% and 14.8%, primarily in the acute phase of infection, and more commonly in those admitted to the intensive care unit ( 90 ).…”

Society of Family Planning Clinical Recommendations: Contraceptive Care in the Context of Pandemic Response

“…This results in a high incidence of venous and arterial thrombosis. Since the beginning of the pandemic, clinicians have reported that the incidence of venous thromboembolism in hospitalized patients with COVID-19 is high, particularly in ICU patients, and even among those who are receiving anticoagulation [87] , [88] , [89] , [90] , [91] . Although this incidence appears to have decreased later in the pandemic in the context of improved treatment, it remains high.…”

A Case of Intracardiac Thrombus in a Recovery Coronavirus Disease 2019 (COVID-19) Patient

“…However, studies have shown that it can be associated with hypercoagulability leading to thromboembolism. Although venous thromboembolism is a common complication associated with COVID-19, arterial thrombosis and intracardiac thrombosis are not frequently described [2][3][4]. Herein, we report a case of a patient presenting to the emergency department with shortness of breath after recovering from COVID-19 a month ago and was found to have intracardiac thrombus.…”