Mortality and risk factors associated with pulmonary embolism in coronavirus disease 2019 patients: a systematic review and meta-analysis

AbstractTo determine, in patients with coronavirus disease 2019 (COVID-19) infection, the associations of pulmonary embolism (PE) with mortality and risk factors for PE as well as the therapeutic benefit of anticoagulant prophylaxis. Embase, PubMed, Cochrane controlled trials register, and Web of Science databases were searched from inception to October 10, 2020. We included all published trials on PE in patients diagnosed with COVID-19 with eligibility of the trials assessed following the PRISMA guidelines. Sixteen clinical trials with 5826 patients were eligible. There were significant associations of PE with the male gender [odd ratio (OR) = 1.59, 95% CI 1.28–1.97], mechanical ventilation (OR = 3.71, 95% CI 2.57–5.36), intensive care unit admission (OR = 2.99, 95% CI 2.11–4.23), circulating D-dimer [mean difference (MD) = 5.04 µg/mL, 95% CI 3.67–6.42) and CRP (MD = 1.97 mg/dL, 95% CI 0.58– 3.35) concentrations without significant correlation between PE and mortality (OR = 1.31, 95% CI 0.82–2.08) as well as other parameters or comorbidities. After omitting one trial with strict patient selection criteria for anticoagulant prophylaxis, significant prophylactic benefit was noted (OR = 0.31, 95% CI 0.1–0.91). Our findings identified the risk factors associated with PE in COVID-19 patients and supported the therapeutic benefit of anticoagulant prophylaxis against PE in this patient population.

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Prevalence and risk factors of thrombotic events on patients with COVID-19: a systematic review and meta‐analysis

Thrombosis Journal ◽

10.1186/s12959-021-00284-9 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Xiaoming Xiong ◽

Jianhua Chi ◽

Qinglei Gao

Keyword(s):

Risk Factors ◽

Web Of Science ◽

Weighted Mean Difference ◽

Meta Analysis ◽

White Blood Cells ◽

Thromboembolism Prophylaxis ◽

Risk Of Death ◽

Coagulation Abnormalities ◽

Male Sex ◽

D Dimer

Abstract Background Coagulation abnormalities in COVID-19 patients accompanied with poor prognosis. This study aimed to determine the prevalence and risk factors of thrombotic events on COVID-19 patients. Methods. We systematically reviewed all the studies about thrombotic events on COVID-19 patients in PubMed, Embase, Web of Science, MedRxiv, bioRxiv, from Dec 1, 2019 to July 5, 2020. The weighted mean difference (MD) or odds ratio (OR) or relative risk (RR) with 95 % confidence intervals (CI) for clinical data in COVID-19 patients with or without thrombotic events was calculated. Results 12 articles contained 1083 patients were included for meta-analysis. The prevalence of thrombosis was 22 % (95 % CI 0.08–0.40) in COVID-19 patients and increased to 43 % (95 % CI 0.29–0.65) after admission to the intensive care unit (ICU). Compared with non-thrombotic patients, thrombotic patients had higher levels of D-dimer (MD = 2.79 μg/ml, 95 % CI 2.27–3.31 μg/ml), lactate dehydrogenase (LDH) (MD = 112.71 U/L, 95 % CI 62.40–163.02 U/L), and white blood cells (WBC) (MD = 1.14 *109/L, 95 % CI 0.47–1.81*109/L) while decreased lymphocytes (MD= -0.20*109/L, 95 % CI -0.38 – -0.02*109/L). Age, platelet counts, and male sex tended to be risks while diabetes tended to be a protection for thrombosis for COVID-19 patients, although no statistical difference was achieved. Finally, patients with thrombosis were at a higher risk of death (OR = 2.39, 95 % CI 1.36–4.20). Conclusions Prevalence of thrombosis in COVID-19 patients was high, especially in ICU, though pharmacologic thromboembolism prophylaxis was applied. Therefore, higher levels of D-dimer, LDH, WBC, and decreased lymphocytes needed to be paid close attention to in patients with COVID-19.

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Predictive Factors of Pulmonary Embolism in Older Patients with SARS-CoV-2: The OCTA-COVID-19 Study

Journal of Clinical Medicine ◽

10.3390/jcm10132998 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2998

Author(s):

Maribel Quezada-Feijoo ◽

Mónica Ramos ◽

Isabel Lozano-Montoya ◽

Rocío Toro ◽

Javier Jaramillo-Hídalgo ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Older Patients ◽

Observational Cohort Study ◽

Time To Event ◽

Cutoff Value ◽

Factors Associated ◽

Observational Cohort ◽

Youden’S Index ◽

D Dimer

Background: The risk of pulmonary embolism (PE) has not been studied in older patients affected by COVID-19. We aimed to assess PE incidence and risk factors in a population of older patients infected with SARS-CoV-2. Methods: An ambispective, observational cohort study. A total of 305 patients ≥ 75 years old had the SARS-CoV-2 infection from March to May 2020. The incidence rate of PE was estimated as the proportion of new cases within the whole sample. Youden’s index was used to assess the cutoff point of D-dimer. To select factors associated with the risk of PE, time-to-event analyses were performed using cause-specific hazard models. Results: In total, 305 patients with a median age of 87 years (62.3% female) were studied; 67.9% were referred from nursing homes and 90.4% received any type of anticoagulation. A total of 64.9% showed frailty and 44% presented with dementia. The PE incidence was 5.6%. The cutoff value of a D-dimer level over 2.59 mg/L showed a sensitivity of 82.4% and specificity of 73.8% in discriminating a PE diagnosis. In the multivariate analysis, the factors associated with PE were previous oncological events and D-dimer levels. Conclusions: The PE incidence was 5.6%, and major risk factors for PE were oncological antecedents and increased plasma D-dimer levels.

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A cohort study of 223 patients explores the clinical risk factors for the severity diagnosis of COVID-19

10.1101/2020.04.18.20070656 ◽

2020 ◽

Author(s):

Yongsheng Huang ◽

Xiaoyu Lyu ◽

Dan Li ◽

Yujun Wang ◽

Lin Wang ◽

...

Keyword(s):

Risk Factors ◽

Case Fatality Rate ◽

Large Scale ◽

Meta Analysis ◽

Development Program ◽

Case Fatality ◽

Fatality Rate ◽

Factors Associated ◽

Severe Group ◽

D Dimer

AbstractBACKGROUNDCoronavirus Disease 2019 (COVID-19) has recently become a public emergency and a worldwide pandemic. The clinical symptoms of severe and non-severe patients vary, and the case-fatality rate (CFR) in severe COVID-19 patients is very high. However, the information on the risk factors associated with the severity of COVID-19 and of their prognostic potential is limited.METHODSIn this retrospective study, the clinical characteristics, laboratory findings, treatment and outcome data were collected and analyzed from 223 COVID-19 patients stratified into 125 non-severe patients and 98 severe patients. In addition, a pooled large-scale meta-analysis of 1646 cases was performed.RESULTSWe found that the age, gender and comorbidities are the common risk factors associated with the severity of COVID-19. For the diagnosis markers, we found that the levels of D-dimer, C-reactive protein (CRP), lactate dehydrogenase (LDH), procalcitonin (PCT) were significantly higher in severe group compared with the non-severe group on admission (D-Dimer: 87.3% vs. 35.3%, P<0.001; CRP, 65.1% vs. 13.5%, P<0.001; LDH: 83.9% vs. 22.2%, P<0.001; PCT: 35.1% vs. 2.2%, P<0.001), while the levels of aspartate aminotransferase (ASP) and creatinine kinase (CK) were only mildly increased. We also made a large scale meta-analysis of 1646 cases combined with 4 related literatures, and further confirmed the relationship between the COVID-19 severity and these risk factors. Moreover, we tracked dynamic changes during the process of COVID-19, and found CRP, D-dimer, LDH, PCT kept in high levels in severe patient. Among all these markers, D-dimer increased remarkably in severe patients and mostly related with the case-fatality rate (CFR). We found adjuvant antithrombotic treatment in some severe patients achieved good therapeutic effect in the cohort.CONCLUSIONSThe diagnosis markers CRP, D-dimer, LDH and PCT are associated with severity of COVID-19. Among these markers, D-dimer is sensitive for both severity and CFR of COVID-19. Treatment with heparin or other anticoagulants may be beneficial for COVID-19 patients.FundingThis study was supported by funding from the National Key Research and Development Program of China (2016YFC1302203); Beijing Nova Program (grant number: xx2018040).Role of the funding sourceThe funding listed above supports this study, but had no role in the design and conduct of the study.

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A Systematic Review and Meta-Analysis of Risk Factors Associated with Severity and Death in COVID-19 Patients

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2021/6660930 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Pengqiang Du ◽

Dandan Li ◽

Aifeng Wang ◽

Su Shen ◽

Zhichao Ma ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Respiratory Diseases ◽

Web Of Science ◽

Meta Analysis ◽

Advanced Age ◽

Severe Illness ◽

Chronic Respiratory Diseases ◽

Factors Associated ◽

Comprehensive Search

This meta-analysis aims to screen the risk factors for severe illness and death and provide help for early clinical treatment of the new coronavirus (COVID-19). Based on a comprehensive search of PubMed, Embase, and Web of Science databases, we included studies that explored the cause and risk factors for severe illness and death in COVID-19 patients. We evaluated the strength of this relationship using odds ratios (ORs) with 95% confidence intervals (CIs). A total of 17 articles were included; 16 of the 17 articles were from China, and the risk factors associated with severe illness and death were age, sex, and multiple comorbidities. Advanced age (≥65 years, severe illness, OR = 2.62; death, OR = 6.00), male (severe illness, OR = 1.49; death, OR = 1.54), chronic respiratory diseases (severe illness, OR = 5.67; death, OR = 3.72), diabetes (severe illness, OR = 3.27; death, OR = 2.60), hypertension (severe illness, OR = 3.08; death, OR = 3.53), chronic kidney disease (severe illness, OR = 3.59; death, OR = 5.38), and cardiovascular diseases (severe illness, OR = 3.87; death, OR = 4.91) were all risk factors. For COVID-19 patients, advanced age, male, and patients with chronic disease are at higher risk of developing severe illness or even death.

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Prevalence and risk factors associated with preterm birth in India: Systematic review and meta-analysis

Authorea ◽

10.22541/au.158758076.65534162 ◽

2020 ◽

Author(s):

Thangjam Devi ◽

Huidrom Singh

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Preterm Birth ◽

Meta Analysis ◽

Factors Associated

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Systematic Review and Meta-Analysis of the Dose-Response and Risk Factors for Obliteration of Arteriovenous Malformations Following Radiosurgery: An Update Based on the Last 20 Years of Published Clinical Evidence

Neurosurgery Open ◽

10.1093/neuopn/okab004 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Shaoyu Zhu ◽

N Patrik Brodin ◽

Madhur K Garg ◽

Patrick A LaSala ◽

Wolfgang A Tomé

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Dose Response ◽

Meta Analysis ◽

Gamma Knife Radiosurgery ◽

Lesion Size ◽

Intracranial Arteriovenous Malformation ◽

Factors Associated ◽

Obliteration Rate ◽

Inverse Variance

ABSTRACT BACKGROUND Intracranial arteriovenous malformation (AVM) is a congenital lesion that can potentially lead to devastating consequences if not treated. Many institutional cohort studies have reported on the outcomes after radiosurgery and factors associated with successful obliteration in the last few decades. OBJECTIVE To quantitatively assess the dose-response relationship and risk factors associated with AVM obliteration using a systematic review and meta-analysis approach. METHODS Data were extracted from reports published within the last 20 yr. The dose-response fit for obliteration as a function of marginal dose was performed using inverse-variance weighting. Risk factors for AVM obliteration were assessed by combining odds ratios from individual studies using inverse-variance weighting. RESULTS The logistic model fit showed a clear association between higher marginal dose and higher rates of obliteration. There appeared to be a difference in the steepness in dose-response when comparing studies with patients treated using Gamma Knife radiosurgery (Elekta), compared to linear accelerators (LINACs), and when stratifying studies based on the size of treated AVMs. In the risk-factor analysis, AVM obliteration rate decreases with larger AVM volume or AVM diameter, higher AVM score or Spetzler-Martin (SM) grade, and prior embolization, and increases with compact AVM nidus. No statistically significant associations were found between obliteration rate and age, sex, prior hemorrhage, prior aneurysm, and location eloquence. CONCLUSION A marginal dose above 18 Gy was generally associated with AVM obliteration rates greater than 60%, although lesion size, AVM score, SM grade, prior embolization, and nidus compactness all have significant impact on AVM obliteration rate.

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Risk factors associated with the development of oral mucositis in pediatric oncology patients: Systematic review and meta‐analysis

Oral Diseases ◽

10.1111/odi.13863 ◽

2021 ◽

Author(s):

Amanda de Farias Gabriel ◽

Felipe Martins Silveira ◽

Marina Curra ◽

Lauren Frenzel Schuch ◽

Vivian Petersen Wagner ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Oral Mucositis ◽

Pediatric Oncology ◽

Meta Analysis ◽

Oncology Patients ◽

Factors Associated

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Prognostic factors for mortality in invasive pneumococcal disease in adult: a system review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-91234-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hao Chen ◽

Hiromi Matsumoto ◽

Nobuyuki Horita ◽

Yu Hara ◽

Nobuaki Kobayashi ◽

...

Keyword(s):

Invasive Pneumococcal Disease ◽

Odds Ratio ◽

Pneumococcal Disease ◽

Web Of Science ◽

Meta Analysis ◽

Mortality Rates ◽

Solid Organ ◽

Factors Associated ◽

System Review ◽

Overall Mortality

AbstractRisk factors associated with mortality in invasive pneumococcal disease remain unclear. The present work is a meta-analysis of studies that enrolled only patients with invasive pneumococcal disease and reported on mortality. Potentially eligible reports were identified from PubMed, CHAHL, and Web of Science, comprising 26 reports in total. Overall mortality for invasive pneumococcal disease was reported as 20.8% (95% confidence interval (CI) 17.5–24%). Factors associated with mortality were age (odds ratio (OR) 3.04, 95% CI 2.5–3.68), nursing home (OR 1.62, 95% CI 1.13–2.32), nosocomial infection (OR 2.10, 95% CI 1.52–2.89), septic shock (OR 13.35, 95% CI 4.54–39.31), underlying chronic diseases (OR 2.34, 95% CI 1.78–3.09), solid organ tumor (OR 5.34, 95% CI 2.07–13.74), immunosuppressed status (OR 1.67, 95% CI 1.31–2.14), and alcohol abuse (OR 3.14, 95% CI 2.13–4.64). Mortality rates with invasive pneumococcal disease remained high, and these findings may help clinicians provide appropriate initial treatment for this disease.

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