A systematic review and meta-analysis of racial disparities in deep vein thrombosis and pulmonary embolism events in patients hospitalized with coronavirus disease 2019

Shivang Bhakta; Young Erben; Devang Sanghavi; Susana Fortich; Yupeng Li; Mohammed M Hasan; Yue Dong; Tara J Brigham; Michael A Edwards; James F Meschia; Pablo Moreno Franco

doi:10.1016/j.jvsv.2022.03.003

A systematic review and meta-analysis of racial disparities in deep vein thrombosis and pulmonary embolism events in patients hospitalized with coronavirus disease 2019

J Vasc Surg Venous Lymphat Disord. 2022 Jul;10(4):939-944.e3. doi: 10.1016/j.jvsv.2022.03.003. Epub 2022 Mar 17.

Authors

Affiliations

¹ Department of Critical Care, Mayo Clinic, Jacksonville, FL.
² Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL. Electronic address: [email protected].
³ Department of Critical Care, Mayo Clinic, Jacksonville, FL; Department of Transplant, Mayo Clinic, Jacksonville, FL.
⁴ Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL.
⁵ Department of Political Science and Economics, Rowan University, Glassboro, NJ.
⁶ Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
⁷ Mayo Clinic Libraries, Mayo Clinic, Jacksonville, FL.
⁸ Department of General Surgery, Mayo Clinic, Jacksonville, FL.
⁹ Department of Neurology, Mayo Clinic, Jacksonville, FL.

Abstract

Objective: Coronavirus disease 2019 (COVID-19) is associated with an increased risk of venous thromboembolism (VTE). Recent studies have characterized racial disparities in the incidence of VTE. The aim of our study was to present a systematic review and meta-analysis to assess the association between race and VTE in patients hospitalized with COVID-19.

Methods: We performed a systematic literature review to evaluate the number of deep vein thrombosis (DVT) and pulmonary embolism (PE) events reported by racial groups in patients hospitalized with COVID-19. For the qualitative analysis, independent reviewers extracted the data from eligible studies, and we used the Newcastle-Ottawa scale to assess the quality of design and content for accurate interpretation. For the quantitative analysis, we pooled the odds ratios with Der Simonian and Laird random effects models.

Results: The qualitative analysis included 11 studies, with 6 included in the meta-analysis. All studies were observational, retrospective cohort studies, except for one retrospective case-control study. Six studies were eligible for the meta-analysis owing to the high interstudy heterogeneity; thus, the variable reports of racial groups reduced the cohort to Black/African American and White patients (n = 9723) in the analysis. The estimated proportion for DVT and PE events for Black/African American and White patients was 0.07 (95% confidence interval, 0.00-0.10) and 0.04 (95% confidence interval, 0.00-0.07), respectively. The P value of .13 suggested nonsignificant differences in the VTE rates between Black/African American and White patients.

Conclusions: In our study, the proportion of DVT and PE events between Black/African American and White patients with COVID-19 were comparable. Future COVID-19 studies should include systematic racial group reporting to identify any disparities in the setting of VTE events.

Keywords: COVID-19; Deep vein thrombosis; Pulmonary embolism; Racial disparities; Venous thromboembolism.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

COVID-19* / complications
Case-Control Studies
Humans
Pulmonary Embolism* / diagnosis
Pulmonary Embolism* / epidemiology
Retrospective Studies
Risk Factors
Venous Thromboembolism* / diagnosis
Venous Thromboembolism* / epidemiology
Venous Thrombosis* / diagnosis
Venous Thrombosis* / epidemiology