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

Henrina, Joshua; Santosa Putra, Iwan Cahyo; Cahyadi, Irvan; Lawrensia, Sherly; Hadi Gunawan, Hoo Felicia; Cahyadi, Alius; Franke, Jennifer; Suciadi, Leonardo Paskah

Venous thromboembolism is prevalent in hospitalized COVID-19 patients. Through systematic review and meta-analysis, we have investigated the differences in clinical characteristics and outcome of hospitalized COVID-19 patients with (+) and without (-) venous thromboembolism (VTE). 45 studies with a total of 8859 patients were included in the qualitative synthesis. Subsequently, 38 studies with a total of 7847 patients, were quantitatively analysed. There was no mortality difference between the VTE (-) and VTE (+) hospitalized COVID-19 patients (RR1.32 (0.97, 1.79); 0.07; I 2 64%, p<0.001). Patients with VTE (+) were more likely to get admitted to the intensive care unit (RR1.77 (1.26, 2.50); p<0.001; I 2 63%, p= 0.03) and mechanically ventilated (RR 2.35 (1.22, 4.53); p=0.01; I 2 88%, p<0.001). Moreover, male gender (RR 1.19 (1.14,1.24), p<0.001; I2 0%, p=0.68), increased the risk of VTE. Regarding patients lab values’, VTE (+) was significantly associated with higher white blood cell, neutrophil count, D-Dimer, alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and C-reactive protein (CRP), along with prolonged prothrombin time. On the contrary, VTE (+) was associated with lower albumin and neutrophil-lymphocyte ratio (NLR). This findings provide the initial framework for risk stratification of hospitalized COVID-19 patients with VTE.