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Prevalence and Risk Factors of Thrombotic Events on Patients with COVID-19: A Systematic Review and Meta-Analysis
Qinglei Gao
tongji hospital of tongji medical college of huazhong university of science and technology
Corresponding Author
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Background
Coagulation abnormalities in COVID-19 patients accompanied with poor prognosis.
This study aimed to determine the prevalence and risk factors of thrombotic events on COVID-19 patients.
Methods
We systematically reviewed all the studies about thrombotic events on COVID-19 patients in PubMed, Embase, Web of Science, MedRxiv, bioRxiv, from Dec 1st, 2019 to July 5, 2020. The weighted mean difference (MD) or odds ratio (OR) or relative risk (RR) with 95% confidence intervals (CI) for clinical data in COVID-19 patients with or without thrombotic events was calculated.
Results
12 articles contained 1083 patients were included for meta-analysis. The prevalence of thrombosis was 22% (95% CI 0.08-0.40) in COVID-19 patients and increased to 43% (95% CI 0.29-0.65) after admission to the intensive care unit (ICU). Compared with non-thrombotic patients, thrombotic patients had higher levels of D-dimer (MD=2.79, 95% CI 2.27–3.31), lactate dehydrogenase (LDH) (MD=112.71, 95% CI 62.40–163.02), and white blood cells (WBC) (MD=1.14, 95% CI 0.47–1.81) while decreased lymphocytes (MD= -0.20, 95% CI -0.38 – -0.02). Age, platelet counts, and male sex tended to be risks while diabetes tended to be a protection for thrombosis for COVID-19 patients, although no statistical difference was achieved. Finally, patients with thrombosis were at a higher risk of death (OR=2.39, 95% CI 1.36–4.20).
Conclusions
Prevalence of thrombosis in COVID-19 patients was high, especially in ICU, though pharmacologic thromboembolism prophylaxis was applied. Therefore, higher levels of D-dimer, LDH, WBC, and decreased lymphocytes needed to be paid close attention to in patients with COVID-19.
Keywords
Thrombosis, COVID-19, Prevalence, Risk factors, Anticoagulants
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This preprint is under consideration at Thrombosis Journal. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Prevalence and Risk Factors of Thrombotic Events on Patients with COVID-19: A Systematic Review and Meta-Analysis
Qinglei Gao
tongji hospital of tongji medical college of huazhong university of science and technology
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 23 Sep, 2020
No community comments so far
Reviewers invited
Invitations sent on 08 Nov, 2020
Editor assigned
On 20 Sep, 2020
Submission checks complete
On 19 Sep, 2020
Editor invited
On 19 Sep, 2020
First submitted
On 18 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Coagulation abnormalities in COVID-19 patients accompanied with poor prognosis.
This study aimed to determine the prevalence and risk factors of thrombotic events on COVID-19 patients.
Methods
We systematically reviewed all the studies about thrombotic events on COVID-19 patients in PubMed, Embase, Web of Science, MedRxiv, bioRxiv, from Dec 1st, 2019 to July 5, 2020. The weighted mean difference (MD) or odds ratio (OR) or relative risk (RR) with 95% confidence intervals (CI) for clinical data in COVID-19 patients with or without thrombotic events was calculated.
Results
12 articles contained 1083 patients were included for meta-analysis. The prevalence of thrombosis was 22% (95% CI 0.08-0.40) in COVID-19 patients and increased to 43% (95% CI 0.29-0.65) after admission to the intensive care unit (ICU). Compared with non-thrombotic patients, thrombotic patients had higher levels of D-dimer (MD=2.79, 95% CI 2.27–3.31), lactate dehydrogenase (LDH) (MD=112.71, 95% CI 62.40–163.02), and white blood cells (WBC) (MD=1.14, 95% CI 0.47–1.81) while decreased lymphocytes (MD= -0.20, 95% CI -0.38 – -0.02). Age, platelet counts, and male sex tended to be risks while diabetes tended to be a protection for thrombosis for COVID-19 patients, although no statistical difference was achieved. Finally, patients with thrombosis were at a higher risk of death (OR=2.39, 95% CI 1.36–4.20).
Conclusions
Prevalence of thrombosis in COVID-19 patients was high, especially in ICU, though pharmacologic thromboembolism prophylaxis was applied. Therefore, higher levels of D-dimer, LDH, WBC, and decreased lymphocytes needed to be paid close attention to in patients with COVID-19.
Figure 1
Figure 2
Figure 3