tetano
Editor, Senior Moderator
Front Cardiovasc Med
. 2022 Jan 25;8:819318.
doi: 10.3389/fcvm.2021.819318. eCollection 2021.
Cumulative Evidence for the Association of Thrombosis and the Prognosis of COVID-19: Systematic Review and Meta-Analysis
Dongqiong Xiao[SUP] 1 2 [/SUP], Fajuan Tang[SUP] 1 2 [/SUP], Lin Chen[SUP] 1 2 [/SUP], Hu Gao[SUP] 1 2 [/SUP], Xihong Li[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Although thrombosis events have been reported in patients with coronavirus disease 2019 (COVID-19), the association between thrombosis and COVID-19-related critical status or risk of mortality in COVID-19 has been inconsistent.
Objective: We conducted a meta-analysis of reports assessing the association between thrombosis and the prognosis of COVID-19.
Methods: The EMBASE, Ovid-MEDLINE, and Web of Science databases were searched up to December 9, 2021, and additional studies were retrieved via manual searching. Studies were included if they reported the risk of COVID-19-related critical status or COVID-19-related mortality in relation to thrombosis. The related data were extracted by two authors independently, and a random effects model was conducted to pool the odds ratios (ORs). In addition, stratified analyses were conducted to evaluate the association.
Results: Among 6,686 initially identified studies, we included 25 studies published in 2020 and 2021, with a total of 332,915 patients according to predefined inclusion criteria. The associations between thrombosis and COVID-19-related mortality and COVID-19-related critical status were significant, with ORs of 2.61 (95% CI, 1.91-3.55, p < 0.05) and 2.9 (95% CI, 1.6-5.24, p < 0.05), respectively. The results were statistically significant and consistent in stratified analyses.
Conclusions: Thrombosis is associated with an increased risk of mortality and critical status induced by COVID-19. Further prospective studies with large sample sizes are required to establish whether these associations are causal by considering more confounders and to clarify their mechanisms.Observational studies cannot prove causality. However, autopsy studies show thrombosis events preceding COVID-19-related deaths. The results of this meta-analysis reported that thrombosis was associated with a 161% increased risk of mortality from COVID-19 and a 190% increased risk of COVID-19-related critical status. The type of thrombosis included in the original studies also seemed to be related to the results.
Keywords: 2019-nCoV; COVID-19; SARS-CoV-2; mortality; thrombosis and COVID-19 thrombosis.
. 2022 Jan 25;8:819318.
doi: 10.3389/fcvm.2021.819318. eCollection 2021.
Cumulative Evidence for the Association of Thrombosis and the Prognosis of COVID-19: Systematic Review and Meta-Analysis
Dongqiong Xiao[SUP] 1 2 [/SUP], Fajuan Tang[SUP] 1 2 [/SUP], Lin Chen[SUP] 1 2 [/SUP], Hu Gao[SUP] 1 2 [/SUP], Xihong Li[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35146009
- PMCID: PMC8821518
- DOI: 10.3389/fcvm.2021.819318
Abstract
Background: Although thrombosis events have been reported in patients with coronavirus disease 2019 (COVID-19), the association between thrombosis and COVID-19-related critical status or risk of mortality in COVID-19 has been inconsistent.
Objective: We conducted a meta-analysis of reports assessing the association between thrombosis and the prognosis of COVID-19.
Methods: The EMBASE, Ovid-MEDLINE, and Web of Science databases were searched up to December 9, 2021, and additional studies were retrieved via manual searching. Studies were included if they reported the risk of COVID-19-related critical status or COVID-19-related mortality in relation to thrombosis. The related data were extracted by two authors independently, and a random effects model was conducted to pool the odds ratios (ORs). In addition, stratified analyses were conducted to evaluate the association.
Results: Among 6,686 initially identified studies, we included 25 studies published in 2020 and 2021, with a total of 332,915 patients according to predefined inclusion criteria. The associations between thrombosis and COVID-19-related mortality and COVID-19-related critical status were significant, with ORs of 2.61 (95% CI, 1.91-3.55, p < 0.05) and 2.9 (95% CI, 1.6-5.24, p < 0.05), respectively. The results were statistically significant and consistent in stratified analyses.
Conclusions: Thrombosis is associated with an increased risk of mortality and critical status induced by COVID-19. Further prospective studies with large sample sizes are required to establish whether these associations are causal by considering more confounders and to clarify their mechanisms.Observational studies cannot prove causality. However, autopsy studies show thrombosis events preceding COVID-19-related deaths. The results of this meta-analysis reported that thrombosis was associated with a 161% increased risk of mortality from COVID-19 and a 190% increased risk of COVID-19-related critical status. The type of thrombosis included in the original studies also seemed to be related to the results.
Keywords: 2019-nCoV; COVID-19; SARS-CoV-2; mortality; thrombosis and COVID-19 thrombosis.