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CC BY 4.0 · TH Open 2022; 06(03): e276-e282
DOI: 10.1055/a-1913-4377
Original Article

Venous and Arterial Thrombosis in Ambulatory and Discharged COVID-19 Patients: A Systematic Review and Meta-analysis

Eman M. Mansory 
1   Department of Medicine, Division of Hematology, Western University, London, Ontario, Canada
2   Department of Hematology, King Abdulaziz University, Jeddah, Saudi Arabia
,
Mohammed Abu-Farhaneh
3   Department of Medicine, Western University, London, Ontario, Canada
,
Alla Iansavitchene
4   Health Sciences Library, London Health Sciences Centre, London, Ontario, Canada
,
Alejandro Lazo-Langner 
1   Department of Medicine, Division of Hematology, Western University, London, Ontario, Canada
5   Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
› Author Affiliations Funding None.
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Abstract

Introduction Venous and arterial thromboses are frequently observed complications in patients with severe novel coronavirus disease 2019 (COVID-19) infection who require hospital admission. In this study, we evaluate the epidemiology of venous and arterial thrombosis events in ambulatory and postdischarge patients with COVID-19 infection.

Materials and Method EMBASE and MEDLINE were searched up to July 21, 2021, in addition to other sources. We included studies that assessed the epidemiology of venous and arterial thrombosis events in ambulatory and postdischarge COVID-19 patients.

Results A total of 16 studies (102,779 patients) were identified. The overall proportion of venous thromboembolic events in all patients, that is, ambulatory and postdischarge, was 0.80% (95% confidence interval [CI]: 0.44–1.28), 0.28% (95% CI: 0.07–0.64), and 1.16% (95% CI: 0.69–1.74), respectively. Arterial events occurred in 0.75% (95% CI: 0.27–1.47) of all patients, 1.45% (95% CI: 1.10–1.86) of postdischarge patients, and 0.23% (95% CI: 0.019–0.66) of ambulatory patients. The pooled incidence rate estimates per 1,000 patient-days for VTE events were 0.06 (95% CI: 0.03–0.08) and 0.12 (95% CI: 0.07–0.19) for outpatients and postdischarge, respectively, whereas for arterial events were 0.10 (95% CI: 0–0.30) and 0.26 (95% CI: 0.16–0.37).

Conclusion This study found a low risk of venous and arterial thrombi in ambulatory and postdischarge COVID-19 patients, with a higher risk in postdischarge patients compared with ambulatory patients. This suggests that regular universal thromboprophylaxis in these patient populations is probably not necessary.

Keywords

thrombosis - ambulatory - outpatients - postdischarge - COVID-19

Supplementary Material



Publication History

Received: 11 February 2022

Accepted: 25 July 2022

Accepted Manuscript online:
29 July 2022

Article published online:
19 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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