Faske Amon, Reis Stefanie, Pscheidl Tamara, Saal-Bauernschubert Lena, Meybohm Patrick, Weibel Stephanie
Department for Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
Crit Care. 2025 May 1;29(1):173. doi: 10.1186/s13054-025-05395-7.
COVID-19 has been associated with an increased risk of thromboembolic complications, particularly in hospitalized patients. While early research focused on pre-Omicron variants, the thrombotic risk associated with SARS-CoV-2 Omicron infections remains unclear. Given the evolving nature of the pandemic, it is critical to assess whether current anticoagulation recommendations remain appropriate.
We conducted a systematic review of clinical studies to determine the incidence of thromboembolic events in COVID-19 patients infected with SARS-CoV-2 Omicron variants. The main outcome was thromboembolic events within 28 days of infection, using objective diagnostic criteria. We systematically searched the Cochrane COVID-19 Study Register, covering multiple databases, for studies published between November 30, 2021, and January 31, 2024. Studies were screened independently by two reviewers, and missing data were requested from study authors.
Our search identified 7843 records, of which 238 underwent full-text screening. Ultimately, no study met our inclusion criteria due to issues such as lack of Omicron-specific data, inadequate reporting of diagnostic methods, and failure to specify the timing of outcome assessment. Despite contacting study authors, no additional eligible data were obtained.
There is currently no high-quality evidence on the incidence of thromboembolic events in Omicron-infected COVID-19 patients. The absence of relevant studies highlights a critical research gap and raises concerns about the applicability of current anticoagulation guidelines. Future studies should stratify outcomes by SARS-CoV-2 variant, ensure transparent reporting, and provide rigorous diagnostic confirmation to guide clinical decision-making.
新型冠状病毒肺炎(COVID-19)与血栓栓塞并发症风险增加有关,尤其是在住院患者中。早期研究聚焦于奥密克戎变异株出现之前的毒株,而与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)奥密克戎感染相关的血栓形成风险仍不明确。鉴于疫情的不断演变,评估当前的抗凝建议是否仍然适用至关重要。
我们对临床研究进行了系统评价,以确定感染SARS-CoV-2奥密克戎变异株的COVID-19患者发生血栓栓塞事件的发生率。主要结局为感染后28天内的血栓栓塞事件,采用客观诊断标准。我们系统检索了Cochrane COVID-19研究注册库,该注册库涵盖多个数据库,以查找2021年11月30日至2024年1月31日期间发表的研究。由两名审阅者独立筛选研究,并向研究作者索要缺失数据。
我们的检索共识别出7843条记录,其中238条进行了全文筛选。最终,由于缺乏奥密克戎特异性数据、诊断方法报告不充分以及未明确结局评估时间等问题,没有研究符合我们的纳入标准。尽管与研究作者进行了联系,但未获得额外的合格数据。
目前尚无关于奥密克戎感染的COVID-19患者血栓栓塞事件发生率的高质量证据。相关研究的缺乏凸显了一个关键的研究空白,并引发了对当前抗凝指南适用性的担忧。未来的研究应按SARS-CoV-2变异株对结局进行分层,确保透明报告,并提供严格的诊断确认,以指导临床决策。