Thromboprophylaxis for outpatients with COVID-19: a Systematic Review and Meta-analysis

Department

Internal Medicine

Document Type

Article

Publication Title

Journal of Thrombosis and Thrombolysis

Abstract

Patients with COVID-19 develop an increased risk of thromboembolism. Thromboprophylaxis is recommended for hospitalized COVID-19 patients, but the role of thromboprophylaxis in outpatients with COVID-19 is less well defined. We conducted a systematic review and meta-analysis to evaluate the safety and efficacy of thromboprophylaxis among outpatients with COVID-19. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from inception to August 2023. The outcomes of interest were venous thromboembolic events including deep venous thrombosis and pulmonary embolism, all-cause mortality, cardiovascular events, hospitalization, major bleeding events, and non-major bleeding events. We included 6 trials comprising 3352 patients. Patients who received thromboprophylaxis had an approximately 70% reduction in venous thromboembolism (RR, 0.28 [95% CI, 0.08 to 0.93]) compared to patients who did not receive thromboprophylaxis. The risk of mortality (RR, 0.79 [95% CI, 0.35 to 1.77]), cardiovascular events (RR, 0.91 [95% CI, 0.30 to 2.73]), and hospitalization (RR, 1.09 [95% CI, 0.81 to 1.47]) were similar between the two groups. Patients who received thromboprophylaxis had a higher risk of non-major bleeding (RR, 3.48 [95% CI, 1.72 to 7.05) compared to patients who did not receive thromboprophylaxis. Thromboprophylaxis reduced the risk of venous thromboembolism but not mortality, cardiovascular events, or hospitalization among outpatients with COVID-19.

First Page

784

Last Page

787

DOI

10.1007/s11239-024-02966-3

Volume

57

Issue

5

Publication Date

6-1-2024

Medical Subject Headings

Humans; COVID-19 (complications, mortality); Venous Thromboembolism (prevention & control, etiology); Hemorrhage (chemically induced); Outpatients; Hospitalization; Anticoagulants (therapeutic use, adverse effects); SARS-CoV-2; Pulmonary Embolism (prevention & control, etiology); Ambulatory Care

PubMed ID

38671166

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