Imperial College London
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Prof. Diana Gorog

Faculty of Medicine, National Heart & Lung Institute

Honorary Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 7034 8934d.gorog

 
 
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Location

 

Royal BromptonRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Jenner:2021:10.1007/s11239-021-02394-7,
author = {Jenner, WJ and Kanji, R and Mirsadraee, S and Gue, YX and Price, S and Prasad, S and Gorog, DA},
doi = {10.1007/s11239-021-02394-7},
journal = {Journal of Thrombosis and Thrombolysis},
pages = {595--607},
title = {Thrombotic complications in 2928 patients with COVID-19 treated in intensive care: a systematic review},
url = {http://dx.doi.org/10.1007/s11239-021-02394-7},
volume = {51},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - A prothrombotic state is reported with severe COVID-19 infection, which can manifest in venous and arterial thrombotic events. Coagulopathy is reflective of more severe disease and anticoagulant thromboprophylaxis is recommended in hospitalized patients. However, the prevalence of thrombosis on the intensive care unit (ICU) remains unclear, including whether this is sufficiently addressed by conventional anticoagulant thromboprophylaxis. We aimed to identify the rate of thrombotic complications in ICU-treated patients with COVID-19, to inform recommendations for diagnosis and management. A systematic review was conducted to assess the incidence of thrombotic complications in ICU-treated patients with COVID-19. Observational studies and registries reporting thrombotic complications in ICU-treated patients were included. Information extracted included patient demographics, use of thromboprophylaxis or anticoagulation, method of identifying thrombotic complications, and reported patient outcomes. In 28 studies including 2928 patients, thrombotic complications occurred in 34% of ICU-managed patients, with deep venous thrombosis reported in 16.1% and pulmonary embolism in 12.6% of patients, despite anticoagulant thromboprophylaxis, and were associated with high mortality. Studies adopting systematic screening for venous thrombosis with Duplex ultrasound reported a significantly higher incidence of venous thrombosis compared to those relying on clinical suspicion (56.3% vs. 11.0%, p < 0.001). Despite thromboprophylaxis, there is a very high incidence of thrombotic complications in patients with COVID-19 on the ICU. Systematic screening identifies many thrombotic complications that would be missed by relying on clinical suspicion and should be employed, with consideration given to increased dose anticoagulant thromboprophylaxis, whilst awaiting results of prospective trials of anticoagulation in this cohort.
AU  - Jenner,WJ
AU  - Kanji,R
AU  - Mirsadraee,S
AU  - Gue,YX
AU  - Price,S
AU  - Prasad,S
AU  - Gorog,DA
DO  - 10.1007/s11239-021-02394-7
EP  - 607
PY  - 2021///
SN  - 0929-5305
SP  - 595
TI  - Thrombotic complications in 2928 patients with COVID-19 treated in intensive care: a systematic review
T2  - Journal of Thrombosis and Thrombolysis
UR  - http://dx.doi.org/10.1007/s11239-021-02394-7
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000617817800001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://link.springer.com/article/10.1007%2Fs11239-021-02394-7
UR  - http://hdl.handle.net/10044/1/91208
VL  - 51
ER  -
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