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

Maddalena Alessandra Wu1,2, Alba Taino1, Pietro Facchinetti3

  • 1Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20156 Milan, Italy.

Journal of Clinical Medicine
|March 28, 2024
PubMed

Insights

COVID-19 patients with venous thromboembolism (VTE) showed fewer comorbidities and a lower mortality rate compared to non-COVID-19 patients. Management involved shorter anticoagulation courses for COVID-19-associated VTE, with no fatalities observed in this group.

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.

Keywords:
COVID-19deep vein thrombosismanagementoutcomespulmonary embolismvenous thromboembolism

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