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dc.contributor.authorJenner, William
dc.contributor.authorKanji, Rahim
dc.contributor.authorMirsadraee, Saeed
dc.contributor.authorGue, Ying X.
dc.contributor.authorPrice, Susanna
dc.contributor.authorPrasad, Sanjay
dc.contributor.authorGorog, Diana
dc.date.accessioned2021-05-11T23:09:11Z
dc.date.available2021-05-11T23:09:11Z
dc.date.issued2021-04-01
dc.identifier.citationJenner , W , Kanji , R , Mirsadraee , S , Gue , Y X , Price , S , Prasad , S & Gorog , D 2021 , ' Thrombotic complications in 2,928 patients with COVID-19 treated in intensive care: a systematic review ' , Journal of Thrombosis and Thrombolysis , vol. 51 , no. 3 , pp. 595–607 . https://doi.org/10.1007/s11239-021-02394-7
dc.identifier.issn0929-5305
dc.identifier.otherPURE: 24465967
dc.identifier.otherPURE UUID: 1f66bdf9-6166-40df-9218-f3335902bf41
dc.identifier.otherScopus: 85100843753
dc.identifier.urihttp://hdl.handle.net/2299/24477
dc.description© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, http://creativecommons.org/licenses/by/4.0/.
dc.description.abstractA 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.en
dc.format.extent13
dc.language.isoeng
dc.relation.ispartofJournal of Thrombosis and Thrombolysis
dc.rightsOpen
dc.titleThrombotic complications in 2,928 patients with COVID-19 treated in intensive care: a systematic reviewen
dc.contributor.institutionDepartment of Clinical, Pharmaceutical and Biological Science
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionSchool of Life and Medical Sciences
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2021-04-01
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1007/s11239-021-02394-7
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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