Clinical Characteristics and Outcomes of Venous Thromboembolism in Patients Hospitalized for COVID-19: Systematic Review and Meta-Analysis

Henrina, J.; Putra, I. C. S.; Cahyadi, I.; Gunawan, H. F. H.; Cahyadi, A.; Suciadi, L. P.

Objective: To investigate the clinical characteristics and outcomes of Coronavirus Disease of 2019 (COVID-19) patients complicated with venous thromboembolism (VTE) Method: We performed a comprehensive literature search of several databases to find studies that assessed VTE in hospitalized COVID-19 patients with a primary outcome of all-cause mortality and secondary outcomes of intensive care unit (ICU) admission and mechanical ventilation. We also evaluated the clinical characteristics of VTE sufferers. Results: Eight studies have been included with a total of 1237 pooled subjects. Venous thromboembolism was associated with higher mortality (2.48 (1.35, 4.55), p=0.003; I2 5%, p=0.35) after we performed sensitivity analysis, ICU admission (RR 2.32 (1.53, 3.52), p<0.0001; 80%, p <0.0001), and mechanical ventilation need (RR 2.73 (1.56, 4.78), p=0.0004; 77%, p=0.001). Furthermore, it was also associated to male gender (RR 1.21 (1.08, 1.35), p=0.0007; I2 12%, p=0.34), higher white blood cells count (MD 1.24 (0.08, 2.41), 0.04; I2 0%; 0.26), D-dimer (MD 4.49 (2.74, 6.25), p<0.00001; I2 67%, p=0.009) and LDH levels (MD 70.93 (19.33, 122.54), p<0.007; I2 21%, p=0.28). In addition, after sensitivity analysis was conducted, VTE also associated with older age (MD 2.79 (0.06, 5.53), p=0.05; I2 25%, p=0.24) and higher CRP levels (MD 2.57 (0.88, 4.26); p=0.003; I2 0%, p=0.96). Conclusion: Venous thromboembolism in COVID-19 patients was associated with increased mortality, ICU admission, and mechanical ventilation requirement. Male gender, older age, higher levels of biomarkers, including WBC count, D-Dimer, and LDH were also being considerably risks for developing VTE in COVID-19 patients during hospitalization.