Venous Thromboembolism Management throughout the COVID-19 Era: Addressing Acute and Long-Term Challenges

Area of Science:

• Cardiology
• Infectious Diseases
• Hematology

Background:

• COVID-19 is linked to an increased risk of venous thromboembolism (VTE) via immunothrombosis mechanisms.
• Limited data compare VTE management and outcomes in acute and long-term follow-up between COVID-19 and non-COVID-19 patients.

Purpose of the Study:

• To investigate and compare the acute and long-term management and complications of VTE in patients with and without COVID-19.

Main Methods:

• Prospective, observational, single-center cohort study.
• Follow-up of VTE patients from acute care to 24 months post-diagnosis.
• Comparison of clinical characteristics, treatment, and outcomes between COVID-19-associated VTE and non-COVID-19 VTE cohorts.

Main Results:

• 157 patients (30 COVID-19, 127 non-COVID-19) were enrolled with a mean follow-up of 10.8 months.
• COVID-19 patients had fewer comorbidities, a higher proportion of pulmonary embolism at baseline, and a lower probability of remaining on anticoagulation therapy after three months.
• No fatalities occurred in COVID-19 patients, contrasting with a 9.4% mortality rate in the non-COVID-19 group (p=0.027). Major hemorrhagic events and VTE recurrence rates were similar between groups.

Conclusions:

• COVID-19-associated VTE patients demonstrate distinct clinical characteristics and outcomes, including significantly lower mortality.
• Personalized, risk-based approaches are crucial for VTE management, potentially involving shorter anticoagulation courses for COVID-19 patients.
• Further research into tailored anticoagulation strategies for different VTE risk subsets is warranted.