A systematic review and meta-analysis of incidence, prognosis, and laboratory indicators of venous thromboembolism in hospitalized patients with coronavirus disease 2019.
A systematic review and meta-analysis of incidence, prognosis, and laboratory indicators of venous thromboembolism in hospitalized patients with coronavirus disease 2019.
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2019年冠状病毒病住院患者静脉血栓栓塞发生率、预后和实验室指标的系统回顾和荟萃分析
DOI：
10.1016/j.jvsv.2021.01.012
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Qu L
中科院分区：
文献类型：
--
作者：
Liu Y;Cai J;Wang C;Jin J;Qu L
我们总结了2019冠状病毒病（COVID-19）住院患者静脉血栓栓塞（VTE）的发生率、抗凝治疗组、实验室特征和死亡率。在系统检索PubMed、Embase、科克伦图书馆、MedRxiv和BioRxiv后，根据PRISMA（系统综述和荟萃分析的首选报告项目）声明的指南，对18项回顾性、6项前瞻性观察性和2项横断面研究进行了系统综述和荟萃分析。总体而言，纳入了4382名住院的COVID-19患者。男性患者明显多于女性（比值比[OR]，1.59; 95%可信区间[CI]，1.25-2.02; P <0.001）。COVID-19患者中VTE的总发生率为28.3%（95%CI，21.6%-35.4%），其中重度和一般COVID-19患者的发生率分别为38.0%（95%CI，29.1%-47.4%）和17.2%（95%CI，11.4%-23.8%）。下肢深静脉血栓形成（DVT）的总发生率为18.3%（95%CI，10.8%~ 27.2%）。在重度和一般COVID-19患者中，DVT的发生率分别为22.1%（95%CI，11.0%-35.5%）和12.8%（95%CI，5.0%-23.3%）。肺栓塞的总发生率为17.6%（95%CI，12.3%~ 23.5%），其中重度病例的发生率为21.7%（95%CI，14.8%~ 29.3%），一般病例的发生率为12.5%（95%CI，6.1%~ 23.5%）。当COVID-19严重程度未分类时，VTE患者的死亡率（25.2%; 95%CI，12.2%-40.5%）并不显著高于无VTE患者（10.2%; 95%CI，3.4%-19.5%; OR，1.88; 95%CI，0.46-7.64; P = 0.377）。然而，在重度COVID-19患者中，发生VTE的患者的死亡率显著高于未发生VTE的患者（OR，2.02; 95% CI，1.15-3.53; P = 0.014）。在多项研究中，患有COVID-19和VTE的患者的D-二聚体水平显著高于没有VTE的类似患者。在COVID-19住院患者中，特别是在重度COVID-19患者中，VTE、DVT和肺栓塞的发生率很高。严重COVID-19和VTE患者的死亡率明显高于无VTE的类似患者。D-二聚体水平升高可能是COVID-19患者发生VTE的指标。
We have summarized the incidence, anticoagulation panels, laboratory characteristics, and mortality of venous thromboembolism (VTE) in hospitalized patients with coronavirus disease 2019 (COVID-19). After systematically searching PubMed, Embase, the Cochrane Library, MedRxiv, and BioRxiv, a systematic review and meta-analysis of 18 retrospective, 6 prospective observational, and 2 cross-sectional studies was performed according to the guidelines of the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement. Overall, 4382 hospitalized patients with COVID-19 were included. Men accounted for significantly more patients than did women (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.25-2.02; P < .001). The total incidence of VTE among the patients with COVID-19 was 28.3% (95% CI, 21.6%-35.4%), with an incidence of 38.0% (95% CI, 29.1%-47.4%) and 17.2% (95% CI, 11.4%-23.8%) among those with severe and general COVID-19, respectively. The total incidence of deep vein thrombosis (DVT) of the lower extremities was 18.3% (95% CI, 10.8%-27.2%). The incidence of DVT was 22.1% (95% CI, 11.0%-35.5%) and 12.8% (95% CI, 5.0%-23.3%) in those with severe and general COVID-19, respectively. The total incidence of pulmonary embolism was 17.6% (95% CI, 12.3%-23.5%), with a rate of 21.7% (95% CI, 14.8%-29.3%) in severe cases and 12.5% (95% CI, 6.1%-23.5%) in general cases. When COVID-19 severity was unclassified, the mortality for the patients with VTE was not significantly greater (25.2%; 95% CI, 12.2%-40.5%) than that for those without VTE (10.2%; 95% CI, 3.4%-19.5%; OR, 1.88; 95% CI, 0.46-7.64; P = .377). However, among the patients with severe COVID-19, those who had developed VTE had significantly greater mortality compared with those without VTE (OR, 2.02; 95% CI, 1.15-3.53; P = .014). The patients with COVID-19 and VTE had significantly higher D-dimer levels than did similar patients without VTE in multiple studies. The occurrence of VTE, DVT, and pulmonary embolism has been substantial among hospitalized patients with COVID-19, especially among those with severe COVID-19. Patients with severe COVID-19 and VTE had significantly greater mortality compared with similar patients without VTE. An increased D-dimer level might be an indicator of the occurrence of VTE in patients with COVID-19.
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影响因子：
4
作者：
Lo CK;Mertz D;Loeb M
通讯作者：
Loeb M
DOI：
10.1164/rccm.202002-0445oc
发表时间：
2020-06-01
影响因子：
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作者：
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影响因子：
3.7
作者：
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通讯作者：
de Jager, C. P. C.