Abstract 14699: Arterial and Venous Thromboembolism in Covid-19: A Study-level Meta-analysis

Abstract

Introduction: The prevalence of venous (VTE) and arterial (ATE) thromboembolic events in patients with COVID-19 remains largely unknown. Methods: In this systematic review and meta-analysis, we systematically searched Pubmed MEDLINE, Google Scholar, and Web of Science for observational studies describing the prevalence of VTE and ATE amongst patients with COVID-19 published between Jan 1, 2020 and May 20, 2020. The websites of major journals were also searched. Results: We analysed findings from 15 studies totalizing 1,755 patients, mainly in intensive care units (ICU). The weighted frequency of COVID-19-related VTE was 16.6% (95%CI 9.5-25.1%, I 2 =94%, 13 studies: 1,546 patients). The overall prevalence of PE and deep vein thrombosis (DVT) were 9.1% (95%CI 3.7-16.6%, I 2 =95%; 15 studies; 1,755 patients) and, 7.8% (95%CI 3.4-13.8%; I 2 =92%; 13 studies; 1,445 patients), respectively. Few were isolated subsegmental PE or distal DVT. The VTE prevalence was significantly higher in ICU (21.6%; 95%CI 12.6-32.2%; I2=91% versus 4.6%; 95%CI 1.0-10.7%, I 2 =87%, p interaction =0.002 in subgroup analysis). The weighted frequency of myocardial infarction/acute coronary syndrome, stroke, and other ATE (6 studies, 812 patients) was 3.2% (95%CI 2.1-4.5%, I 2 =0%), 0.7% (95%CI 0.0-2.2%, I 2 =64%), 2.0% (95%CI 1.2-3.0%, I 2 =40%), and 0.5% (95%CI 0.0-1.6%, I 2 =60%), respectively. Conclusions: Patients admitted in the ICU for severe COVID-19 had a high risk of VTE. Conversely, further studies are needed to determine the specific effects of COVID-19 on the risk of ATE or VTE in less severe forms of the disease.