Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48...

Area of Science:

• Vascular Medicine
• Infectious Diseases
• Epidemiology

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is known to induce a prothrombotic state.
• The long-term impact of COVID-19 on the incidence of vascular diseases remains incompletely understood.
• Understanding these long-term effects is crucial for patient management and public health strategies.

Purpose of the Study:

• To investigate the long-term incidence of vascular diseases following a COVID-19 diagnosis.
• To compare the risk of arterial thromboses and venous thromboembolic events (VTEs) in individuals with and without a history of COVID-19.
• To analyze how COVID-19 severity, demographics, and prior medical history influence vascular event risk.

Main Methods:

• Utilized population-wide, anonymized electronic health records from England and Wales (January 1 to December 7, 2020).
• Included over 1.4 million individuals diagnosed with COVID-19 and a comparable control group.
• Calculated adjusted hazard ratios for arterial thromboses and VTEs, with subgroup analyses based on COVID-19 severity and patient characteristics.

Main Results:

• The adjusted hazard ratio for arterial thrombosis declined from 21.7 in week 1 to 1.34 by weeks 27-49 post-COVID-19 diagnosis.
• The adjusted hazard ratio for VTEs decreased from 33.2 in week 1 to 1.80 by weeks 27-49 post-COVID-19 diagnosis.
• Elevated risks were more pronounced and persisted longer in hospitalized patients, Black or Asian individuals, and those without a prior history of vascular events.

Conclusions:

• The relative incidence of vascular events, particularly arterial thromboses, decreases more rapidly than VTEs after COVID-19 diagnosis but remains elevated for up to 49 weeks.
• Findings support policies promoting COVID-19 vaccination, early post-discharge care, risk factor management, and secondary preventive treatments for high-risk individuals.
• The study highlights the sustained vascular risk associated with COVID-19, underscoring the need for ongoing monitoring and preventive measures.