Abstract：
Patients with COVID-19 develop an increased risk of thromboembolism. Thromboprophylaxis is recommended for hospitalized COVID-19 patients, but the role of thromboprophylaxis in outpatients with COVID-19 is less well defined. We conducted a systematic review and meta-analysis to evaluate the safety and efficacy of thromboprophylaxis among outpatients with COVID-19. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from inception to August 2023. The outcomes of interest were venous thromboembolic events including deep venous thrombosis and pulmonary embolism, all-cause mortality, cardiovascular events, hospitalization, major bleeding events, and non-major bleeding events. We included 6 trials comprising 3352 patients. Patients who received thromboprophylaxis had an approximately 70% reduction in venous thromboembolism (RR, 0.28 [95% CI, 0.08 to 0.93]) compared to patients who did not receive thromboprophylaxis. The risk of mortality (RR, 0.79 [95% CI, 0.35 to 1.77]), cardiovascular events (RR, 0.91 [95% CI, 0.30 to 2.73]), and hospitalization (RR, 1.09 [95% CI, 0.81 to 1.47]) were similar between the two groups. Patients who received thromboprophylaxis had a higher risk of non-major bleeding (RR, 3.48 [95% CI, 1.72 to 7.05) compared to patients who did not receive thromboprophylaxis. Thromboprophylaxis reduced the risk of venous thromboembolism but not mortality, cardiovascular events, or hospitalization among outpatients with COVID-19.
摘要：
COVID-19患者发生血栓栓塞的风险增加。建议住院的COVID-19患者预防血栓，但COVID-19门诊患者血栓预防的作用尚不明确.我们进行了系统评价和荟萃分析，以评估COVID-19门诊患者血栓预防的安全性和有效性。我们搜索了PubMed,Embase,Cochrane中央控制试验登记册,WebofScience,和Scopus从成立到2023年8月。感兴趣的结果是静脉血栓栓塞事件，包括深静脉血栓形成和肺栓塞。全因死亡率,心血管事件,住院治疗,主要出血事件,和非大出血事件。我们纳入了6项试验，包括3352例患者。接受血栓预防的患者静脉血栓栓塞减少约70%(RR，与未接受血栓预防的患者相比，0.28[95％CI，0.08至0.93]）。死亡风险(RR，0.79[95%CI，0.35至1.77])，心血管事件(RR，0.91[95%CI，0.30至2.73])，和住院（RR，1.09[95%CI，0.81至1.47]）两组之间相似。接受血栓预防的患者发生非大出血的风险较高(RR，与未接受血栓预防的患者相比，为3.48[95％CI，1.72至7.05）。血栓预防降低了静脉血栓栓塞的风险，但不降低死亡率。心血管事件,或COVID-19门诊患者的住院治疗。
