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COVID-19 感染出院患者的血栓和出血事件:系统评价和荟萃分析。

Thrombotic and Hemorrhagic Incidences in Patients After Discharge from COVID-19 Infection: A Systematic Review and Meta-Analysis.

机构信息

26685Mahidol University, Bangkok, Thailand.

577110Burapha University, Chonburi, Thailand.

出版信息

Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211069082. doi: 10.1177/10760296211069082.

Abstract

BACKGROUND

The association between coronavirus infection 2019 (COVID-19) and thrombosis has been explicitly shown through numerous reports that demonstrate high rates of thrombotic complications in infected patients. Recently, much evidence has shown that patients who survived COVID-19 might have a high thrombotic risk after hospital discharge. This current systematic review and meta-analysis was conducted to better understand the incidence of thrombosis, bleeding, and mortality rates among patients discharged after COVID-19 hospitalization.

METHODS

Using a search strategy that included terms for postdischarge, thrombosis, and COVID-19, 2 investigators independently searched for published articles indexed in the MEDLINE, Embase, and Scopus databases that were published before August 2021. Pooled incidences and 95% confidence intervals were calculated using the DerSimonian-Laird random-effects model with a double arcsine transformation.

RESULTS

Twenty articles were included in the meta-analysis. They provided a total of 19 461 patients discharged after COVID-19 hospitalization. The weighted pooled incidence of overall thrombosis among the patients was 1.3% (95 CI, 0. 6-2; I 90.5), with a pooled incidence of venous thrombosis of 0.7% (95 CI, 0. 4-1; I 73.9) and a pooled incidence of arterial thrombosis of 0.6% (95 CI, 0. 2-1; I 88.1). The weighted pooled incidences of bleeding and mortality were 0.9% (95 CI, 0. 1-1.9; I 95.1) and 2.8% (95 CI, 0. 6-5; I 98.2 respectively.

CONCLUSIONS

The incidences of thrombosis and bleeding in patients discharged after COVID-19 hospitalization are comparable to those of medically ill patients.

摘要

背景

大量报告明确表明,2019 年冠状病毒病(COVID-19)感染与血栓形成之间存在关联,这些报告显示感染患者的血栓并发症发生率很高。最近,大量证据表明,COVID-19 存活患者在出院后可能存在较高的血栓形成风险。本系统评价和荟萃分析旨在更好地了解 COVID-19 住院患者出院后的血栓形成、出血和死亡率。

方法

使用包括出院后、血栓形成和 COVID-19 等术语的搜索策略,两名调查员独立搜索了在 MEDLINE、Embase 和 Scopus 数据库中发表的、发表时间在 2021 年 8 月之前的文章。使用双反正弦变换的 DerSimonian-Laird 随机效应模型计算汇总发生率和 95%置信区间。

结果

20 篇文章纳入荟萃分析。它们共提供了 19461 例 COVID-19 住院后出院的患者。患者总体血栓形成的加权汇总发生率为 1.3%(95%置信区间,0.6-2;I 90.5),静脉血栓形成的汇总发生率为 0.7%(95%置信区间,0.4-1;I 73.9),动脉血栓形成的汇总发生率为 0.6%(95%置信区间,0.2-1;I 88.1)。出血和死亡率的加权汇总发生率分别为 0.9%(95%置信区间,0.1-1.9;I 95.1)和 2.8%(95%置信区间,0.6-5;I 98.2)。

结论

COVID-19 住院患者出院后的血栓形成和出血发生率与内科疾病患者相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7bf/8689619/ed4710e87375/10.1177_10760296211069082-fig1.jpg

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