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COVID‐19 (SARS‐CoV‐2) infection and thrombotic conditions: A systematic review and meta‐analysis
Author(s) -
GabbaiArmelin Paulo Roberto,
Oliveira Analú Barros,
Ferrisse Túlio Morandin,
Sales Luciana Solera,
Barbosa Elis Rodrigues Oliveira,
Miranda Marina Lins,
Salomão Karina Borges,
Brighenti Fernanda Lourenção
Publication year - 2021
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13559
Subject(s) - medicine , meta analysis , publication bias , cochrane library , diabetes mellitus , funnel plot , covid-19 , disease , infectious disease (medical specialty) , endocrinology
Background COVID‐19 is an infectious disease caused by SARS‐CoV‐2 associated with haematological manifestations (thrombolytic events). Aims Considering the high prevalence of the thrombotic scenarios associated with COVID‐19, the aim of this study was to perform a systematic review of the available literature, concerning the relation of COVID‐19 and the thrombotic events, and identify prognostic factors for these events. Materials & Methods PubMed, Web of Science and Scopus databases were searched. Independent reviewers conducted all flow diagram steps. For qualitative analysis, Oxford level of evidence and Newcastle‐Ottawa scale were used in the eligible articles. For the prognostic factors, a meta‐analysis was conducted to age, number of neutrophils and platelets, and levels of ferritin, C‐reactive protein, lactate dehydrogenase and D‐dimer. Publication bias was accessed by funnel plot and by trim‐and‐fill test. Trim‐and‐fill test was also applied to evaluate meta‐analysis bias. Results Twenty articles were included in the qualitative analysis, and 6 articles were included in the meta‐analysis. Case‐control studies showed bias related to exposure, and the main bias in cohort studies were related to selection and outcome. All articles received score 4 for the level of evidence. Hypertension and diabetes were the comorbidities more frequently associated with thrombolytic events. Significant results were found regarding D‐dimer ( P < .0001) and age ( P = .0202) for thrombotic events in patients diagnosed with COVID‐19. Conclusion Patients older than 60 years, with hypertension, diabetes and D‐Dimer values above 3.17 µg/mL, can be considered prognostic factors for developing thrombotic events due to COVID‐19.