Global epidemiology of venous thromboembolism in people with active tuberculosis: a systematic review and meta-analysis

Background: despite the wide range of studies supporting an association between exposure to active tuberculosis and risk of venous thromboembolism (VTE), the current systematic review and meta-analysis is the first study assessing the global epidemiology of VTE in patients having active tuberculosis (TB). Methods: In this systematic review and meta-analysis, EMBASE, PubMed, and Web of Science were searched to identify observational studies, published until December 15, 2019, and reporting on venous thromboembolism in patients with active tuberculosis. No language restriction was applied. Studies were synthetized using a random-effect model. This review is registered with PROSPERO, CRD42019130347. Results: we included 9 studies with an overall total of 16,190 patients. The prevalence of VTE was 3.5 % (95%CI: 2.2-5.2) in patients with active tuberculosis. Furthermore, we found a prevalence of pulmonary embolism (PE) at 5.8% (95%CI: 2.2-10.7) and for deep vein thrombosis (DVT) at 1.3% (95%CI: 0.8-2.0) in patients with active tuberculosis. Patients with active tuberculosis are more likely to present VTE (OR: 2.90; 95% CI: 2.30-3.67), DVT (OR: 1.56; 95% CI: 1.14-2.14), and PE (OR: 3.58; 95% CI: 2.54-5.05). Conclusion: this study suggests that VTE is not rare among patients with active TB. Cost-effective preventive strategies and interventions to curb this dreadful burden of VTE among people with active TB are needed