• Paulo Roberto Gabbai-Armelin, Analú Barros de Oliveira, Túlio Morandin Ferrisse, Luciana Solera Sales, Elis Rodrigues Oliveira Barbosa, Marina Lins Miranda, Karina Borges Salomão, and Fernanda Lourenção Brighenti.
• School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil.
• Eur. J. Clin. Invest. 2021 Jun 1; 51 (6): e13559.

BackgroundCOVID-19 is an infectious disease caused by SARS-CoV-2 associated with haematological manifestations (thrombolytic events).AimsConsidering the high prevalence of the thrombotic scenarios associated with COVID-19, the aim of this study was to perform a systematic review of the available literature, concerning the relation of COVID-19 and the thrombotic events, and identify prognostic factors for these events.Materials & MethodsPubMed, Web of Science and Scopus databases were searched. Independent reviewers conducted all flow diagram steps. For qualitative analysis, Oxford level of evidence and Newcastle-Ottawa scale were used in the eligible articles. For the prognostic factors, a meta-analysis was conducted to age, number of neutrophils and platelets, and levels of ferritin, C-reactive protein, lactate dehydrogenase and D-dimer. Publication bias was accessed by funnel plot and by trim-and-fill test. Trim-and-fill test was also applied to evaluate meta-analysis bias.ResultsTwenty articles were included in the qualitative analysis, and 6 articles were included in the meta-analysis. Case-control studies showed bias related to exposure, and the main bias in cohort studies were related to selection and outcome. All articles received score 4 for the level of evidence. Hypertension and diabetes were the comorbidities more frequently associated with thrombolytic events. Significant results were found regarding D-dimer (P < .0001) and age (P = .0202) for thrombotic events in patients diagnosed with COVID-19.ConclusionPatients older than 60 years, with hypertension, diabetes and D-Dimer values above 3.17 µg/mL, can be considered prognostic factors for developing thrombotic events due to COVID-19.© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

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