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Oxford University Press - PMC COVID-19 Collection logoLink to Oxford University Press - PMC COVID-19 Collection
. 2020 Nov 17:afaa259. doi: 10.1093/ageing/afaa259

Venous thromboembolic events in patients with COVID-19: A systematic review and meta-analysis

Ting Wu 1,2,#, Zhihong Zuo 3,4,#, Deyi Yang 5,6, Xuan Luo 7, Liping Jiang 8, Zanxian Xia 9,10, Xiaojuan Xiao 11, Jing Liu 12, Mao Ye 13, Meichun Deng 14,15,16,
PMCID: PMC7717132  PMID: 33201226

Abstract

Background

High incidence of venous thromboembolic complications in COVID-19 patients was noted recently.

Objective

This study aimed to explore the factors associated with prevalence of venous thromboembolism (VTE) in COVID-19 patients.

Methods

A literature search was conducted in several online databases. Fixed effects meta-analysis was performed for the factors associated with prevalence of VTE in COVID-19 patients.

Results

A total of 39 studies were analyzed in this analysis. The incidence of pulmonary embolism and VTE in severe COVID-19 patients were 17% (95% CI, 13–21%) and 42% (95% CI, 25–60%), respectively. VTE were more common among individuals with COVID-19 of advance age. Male COVID-19 patients are more likely to experience VTE. Higher levels of white blood cell (WBC; WMD = 1.34×109/L; 95% CI, 0.84–1.84×109/L), D-dimer (WMD = 4.21 ug/mL; 95% CI, 3.77–4.66 ug/mL), activated partial thromboplastin time (APTT; WMD = 2.03 s; 95% CI, 0.83–3.24 s), fibrinogen (WMD = 0.49 ug/mL; 95% CI, 0.18–0.79 g/L) and C-reactive protein (CRP; WMD = 21.89 mg/L; 95% CI, 11.44–32.34 mg/L) were commonly noted in COVID-19 patients with VTE. Patients with lower level of lymphocyte (WMD = −0.15×109/L; 95% CI, −0.23—0.07×109/L) was at high risk of developing VTE. The incidence of severe condition (OR = 2.66; 95% CI, 1.95–3.62) was more likely to occur among COVID-19 patients who developed VTE.

Conclusion

VTE is a common complication in severe COVID-19 patients and thromboembolic events are also associated with adverse outcomes.

Keywords: COVID-19, incidence, clinical features, risk factors, venous thromboembolism, older people


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