Epidemiology of Venous Thromboembolism in SARS-CoV-2 Infected Patients: A Systematic Review and Meta-Analysis

  1. Souvik Maitra
  2. Dalim K Baidya
  3. Sulagna Bhattacharjee
  4. Rahul K Anand
  5. Bikash R Ray

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Abstract

Early reports from China and Europe indicated that incidence of venous thromboembolism in COVID-19 patients may be high. In this meta-analysis of observational studies was designed to know worldwide prevalence of thromboembolic events in COVID-19 patients. Primary outcome of our review was to assess the proportion of patients with VTE. Secondary outcomes were to assess the proportion of patients’ with DVT and proportion of patients with PE. Random effect meta-analysis model with restricted maximum likelihood estimator was used for all analysis. Pooled proportion with 95% confidence interval (95% CI) and heterogeneity (I 2 ) was reported for all outcomes. Data of 5426 patients from n=19 articles were included in this systematic review and meta-analysis. Incidence of VTE (95% CI), PE (95% CI) and DVT (95% CI) was 23 (10-36) %, 12 (6-17) % and 15 (8-23) %. We have found a high but incidence of thromboembolic events in COVID-19 patients. Further well-designed studies are required in this area to identify true incidence and risk factors of it.

    Key Messages

  • This meta-analysis of observational studies was designed to know worldwide prevalence of thromboembolic events in COVID-19 patients.

  • Data of more than 5000 patients from 19 observational studies were analyzed in this meta-analysis.

  • Incidence of venous thromboembolism may be as high as 36% in these patients.

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  1. ScreenIT

    SciScore for 10.1101/2020.08.28.20184028: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Eligible articles for this systematic review and meta-analysis were searched from PubMed and PubMed central with the key words “venous thromboembolism and SARS-CoV-2”, “venous thromboembolism and COVID”, “venous thromboembolism and COVID-19”, “venous thromboembolism and coronavirus”, “VTE and COVID-19”, “VTE and SARS-CoV-2”, “VTE and coronavirus”, “VTE and COVID”, “pulmonary embolism and SARS-CoV-2”, “pulmonary embolism and COVID”, “pulmonary embolism and COVID-19”, “pulmonary embolism and coronavirus”, “PE and SARS-CoV-2”, “PE and COVID”, “PE and COVID-19”, “PE and coronavirus”, “DVT and SARS-CoV-2”, “DVT and COVID”, “DVT and COVID-19”, “DVT and coronavirus”, “deep venous thrombosis and SARS-CoV-2”, “deep venous thrombosis and COVID”, “deep venous thrombosis and COVID-19”, “deep venous thrombosis and coronavirus”, from inception to 26th July 2020.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    All analyses were performed with metafor package in R (R version 3.6.1, R Development Core Team, 2010; R Foundation for Statistical Computing, Vienna, Austria) in Jamovi platform.
    R Development Core
    suggested: (R Project for Statistical Computing, RRID:SCR_001905)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1101/2020.08.28.20184028v1 on medRxiv