Risk of thromboembolic events in non-hospitalized COVID-19 patients: A systematic review.
Eur J Pharmacol
; 941: 175501, 2023 Feb 15.
Article
en En
| MEDLINE
| ID: mdl-36641102
ABSTRACT
The risk of thromboembolism in non-hospitalized COVID-19 patients remains uncertain and was assessed in this review to better weigh benefits vs. risks of prophylactic anticoagulation in this population. A search was performed through three databases Medline, Embase, and Cochrane Library until 2022. Self-controlled case series, case-control and cohort studies were included, and findings summarized narratively. Meta-analyses for risk of thromboembolism including deep vein thrombosis (DVT), pulmonary embolism (PE), and myocardial infarction (MI) between COVID-19 and non-COVID-19 non-hospitalized patients were conducted. Frequency, incidence rate ratio (IRR), and risk ratio (RR) of stroke were used to assess risk in non-hospitalized COVID-19 patients considering the lack of studies to conduct a meta-analysis. Ten studies met inclusion criteria characterized by adult non-hospitalized COVID-19 patients. Risk of bias was relatively low. Risk of DVT (RR 1.98 with 95% CI 1.03-3.83) and PE (OR 6.72 with 95% CI 4.81-9.39 and RR 4.44 with 95% CI 1.98-9.99) increased in non-hospitalized COVID-19 patients compared to controls. Risk of MI (OR 1.91 with 95% CI 0.89-4.09) is possibly increased in non-hospitalized COVID-19 patients with moderate certainty when compared to controls. A trend in favor of stroke was documented in the first week following infection. Our meta-analyses support the increase in risk of DVT and PE, and likely increase of MI, in non-hospitalized COVID-19 patients. The risk of stroke appears significant in the first week following infection but drops to insignificance two weeks later. More studies are needed to establish evidence-based recommendations for prophylactic anticoagulation therapy in non-hospitalized COVID-19 patients.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Embolia Pulmonar
/
Tromboembolia
/
Accidente Cerebrovascular
/
COVID-19
Tipo de estudio:
Etiology_studies
/
Guideline
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Eur J Pharmacol
Año:
2023
Tipo del documento:
Article