Risk of thromboembolic events in non-hospitalized COVID-19 patients: A systematic review.

Adult Humans Anticoagulants / therapeutic use COVID-19 / complications Pulmonary Embolism / etiology Stroke / epidemiology Thromboembolism / epidemiology
Deep vein thrombosis Myocardial infarction Pulmonary embolism SARS-CoV-2 Stroke Thromboembolism

Journal

European journal of pharmacology
ISSN: 1879-0712
Titre abrégé: Eur J Pharmacol
Pays: Netherlands
ID NLM: 1254354

Informations de publication

Date de publication:
15 Feb 2023
Historique:
received: 10 09 2022
revised: 08 01 2023
accepted: 10 01 2023
pubmed: 15 1 2023
medline: 1 2 2023
entrez: 14 1 2023
Statut: ppublish

Résumé

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.

Identifiants

DOI: 10.1016/j.ejphar.2023.175501 PMID: 36641102 PMC: PMC9833853
pubmed: 36641102
pii: S0014-2999(23)00012-2
doi: 10.1016/j.ejphar.2023.175501
pmc: PMC9833853
pii:
doi:

Substances chimiques

Anticoagulants 0

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

175501

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors have no competing interests to declare.

Auteurs

Gaelle P Massoud (GP)

Department of Pharmacology and Toxicology, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon; The Cardiovascular, Renal, and Metabolic Diseases Research Center of Excellence, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon; Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, MD 21205, USA.

Dana H Hazimeh (DH)

Department of Pharmacology and Toxicology, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon; The Cardiovascular, Renal, and Metabolic Diseases Research Center of Excellence, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon; Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, MD 21205, USA.

Ghadir Amin (G)

Department of Pharmacology and Toxicology, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon; The Cardiovascular, Renal, and Metabolic Diseases Research Center of Excellence, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon.

Wissam Mekary (W)

Department of Pharmacology and Toxicology, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon; The Cardiovascular, Renal, and Metabolic Diseases Research Center of Excellence, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon.

Joanne Khabsa (J)

Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.

Tarek Araji (T)

Parker Institute of Cancer and Immunotherapy, University of Pennsylvania, Philadelphia, PA 19104, USA.

Souha Fares (S)

Hariri School of Nursing, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Center of Innovative Design and Analysis, Biostatistics and Informatics, School of Public Health, Colorado University Anschutz Medical Campus, USA.

Mathias Mericskay (M)

Department of Signaling and Cardiovascular Pathophysiology, UMR-S 1180, Inserm, Université Paris-Saclay, France.

George W Booz (GW)

Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

Fouad A Zouein (FA)

Department of Pharmacology and Toxicology, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon; The Cardiovascular, Renal, and Metabolic Diseases Research Center of Excellence, American University of Beirut Medical Center, Faculty of Medicine, Beirut, Lebanon; Department of Signaling and Cardiovascular Pathophysiology, UMR-S 1180, Inserm, Université Paris-Saclay, France; Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA. Electronic address: fz15@aub.edu.lb.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Risk of thromboembolic events in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Risk of thromboembolic events in...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Anticoagulants › Risk of thromboembolic events in...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Risk of thromboembolic events in...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Embolie › Embolie pulmonaire › Risk of thromboembolic events in...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Risk of thromboembolic events in...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thromboembolie › Risk of thromboembolic events in...