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Risk Factors for Venous Thromboembolism in Severe COVID-19: A Study-Level Meta-Analysis of 21 Studies

Author

Listed:
  • Hervé Lobbes

    (Service de Médecine Interne, Hôpital Estaing, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
    Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, UMR 6602, 63000 Clermont-Ferrand, France)

  • Sabine Mainbourg

    (Service de Médecine Interne et Vasculaire, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
    CNRS, Laboratoire de Biométrie et Biologie Evolutive, UMR 5558, University of Lyon, Université Lyon 1, 69100 Villeurbanne, France)

  • Vicky Mai

    (Pulmonary Hypertension Research Group, Institut Universitaire de Cardiologie et de Pneumologie de Québec Research Center, Laval University, Québec, QC G1V 4G5, Canada)

  • Marion Douplat

    (Service d’Accueil des Urgences, Hospices Civils de Lyon, Hôpital Lyon-Sud, 69310 Pierre-Bénite, France
    Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Lyon 1, 69373 Lyon, France)

  • Steeve Provencher

    (Pulmonary Hypertension Research Group, Institut Universitaire de Cardiologie et de Pneumologie de Québec Research Center, Laval University, Québec, QC G1V 4G5, Canada
    These authors contributed equally to this work.)

  • Jean-Christophe Lega

    (Service de Médecine Interne et Vasculaire, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
    CNRS, Laboratoire de Biométrie et Biologie Evolutive, UMR 5558, University of Lyon, Université Lyon 1, 69100 Villeurbanne, France
    Groupe d’Etude Multidisciplinaire des Maladies Thrombotiques, Hospices Civils de Lyon, 69500 Bron, France
    These authors contributed equally to this work.)

Abstract

Venous thromboembolism (VTE) in patients with COVID-19 in intensive care units (ICU) is frequent, but risk factors (RF) remain unidentified. In this meta-analysis (CRD42020188764) we searched for observational studies from ICUs reporting the association between VTE and RF in Medline/Embase up to 15 April 2021. Reviewers independently extracted data in duplicate and assessed the certainty of the evidence using the GRADE approach. Analyses were conducted using the random-effects model and produced a non-adjusted odds ratio (OR). We analysed 83 RF from 21 studies (5296 patients). We found moderate-certainty evidence for an association between VTE and the D-dimer peak (OR 5.83, 95%CI 3.18–10.70), and length of hospitalization (OR 7.09, 95%CI 3.41–14.73) and intubation (OR 2.61, 95%CI 1.94–3.51). We identified low-certainty evidence for an association between VTE and CRP (OR 1.83, 95% CI 1.32–2.53), D-dimer (OR 4.58, 95% CI 2.52–8.50), troponin T (OR 8.64, 95% CI 3.25–22.97), and the requirement for inotropic drugs (OR 1.67, 95% CI 1.15–2.43). Traditional VTE RF (i.e., history of cancer, previous VTE events, obesity) were not found to be associated to VTE in COVID-19. Anticoagulation was not associated with a decreased VTE risk. VTE RF in severe COVID-19 correspond to individual illness severity, and inflammatory and coagulation parameters.

Suggested Citation

  • Hervé Lobbes & Sabine Mainbourg & Vicky Mai & Marion Douplat & Steeve Provencher & Jean-Christophe Lega, 2021. "Risk Factors for Venous Thromboembolism in Severe COVID-19: A Study-Level Meta-Analysis of 21 Studies," IJERPH, MDPI, vol. 18(24), pages 1-17, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:24:p:12944-:d:697705
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