Portal vein thrombosis in patients with COVID-19: A systematic review

Asian J Surg. 2023 Aug;46(8):3017-3026. doi: 10.1016/j.asjsur.2022.11.002. Epub 2022 Nov 11.

Abstract

Several studies have proven that COVID-19 is linked to a higher incidence of different thrombotic events. Thrombosis of the portal vein can result in portal hypertension and can extend to the mesenteric vein resulting in intestinal ischemia. A search of PubMed, Web of Science, and Scopus for relevant studies revealed an association between PVT and COVID-19. This review is structured according to PRISMA guidelines. Thirty-three studies met the inclusion criteria. Twenty-nine case studies/series and four cohort/cross-sectional studies were included. Age at diagnosis was lower when compared to PVT due to cirrhosis. In cohort/cross-sectional studies, males comprised 54.83% of subjects, whereas in case reports/series, males comprised 62.1%. Obesity, asthma, hypertension, and diabetes were the most common comorbidities identified. The majority of the thrombotic events occurred within two weeks. The treatment aimed to prevent thrombus progression and improve recanalization. According to the evidence, early intervention prevents the poor prognosis of intestinal ischemia and its propagation.

Keywords: Anticoagulants; COVID-19; Comorbidities; Portal vein thrombosis.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Anticoagulants
  • COVID-19* / complications
  • Cross-Sectional Studies
  • Female
  • Humans
  • Ischemia / pathology
  • Liver Cirrhosis / complications
  • Male
  • Portal Vein / pathology
  • Thrombosis* / etiology
  • Venous Thrombosis* / epidemiology
  • Venous Thrombosis* / etiology
  • Venous Thrombosis* / therapy

Substances

  • Anticoagulants