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Effect of mild-to-moderate COVID‑19 on the incidence and risk factors for deep vein thrombosis in patients with hip

Haoran Li1, Jian Xing1, Zhe Song1

  • 1Orthopedic Trauma Department, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.

BMC Surgery
|March 25, 2025
PubMed

Insights

Mild-to-moderate COVID-19 did not significantly increase deep vein thrombosis (DVT) risk in hip fracture patients. Routine DVT prevention is recommended for all hip fracture patients, irrespective of SARS-CoV-2 infection status.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Hip fractures are prevalent in the elderly, with a significant proportion occurring in inpatients during the COVID-19 pandemic.
  • COVID-19's impact on deep vein thrombosis (DVT) risk is complex, with higher incidence reported in severe cases.
  • The specific risk of DVT associated with mild-to-moderate COVID-19 in hip fracture patients remains unclear.

Purpose of the Study:

  • To investigate the association between mild-to-moderate COVID-19 and the risk of deep vein thrombosis (DVT) in patients undergoing hip fracture surgery.
  • To identify independent risk factors for preoperative DVT in hip fracture patients.

Main Methods:

  • Retrospective analysis of adult patients who underwent hip fracture surgery between December 2022 and January 2023.
  • Preoperative screening for SARS-CoV-2 infection and Doppler ultrasonography (DUS) for DVT detection.
  • Logistic regression analysis to determine risk factors for DVT.

Main Results:

  • Out of 98 hip fracture patients, 63 tested positive for SARS-CoV-2. Overall DVT incidence was 37% (40% in COVID-19 positive, 31% in COVID-19 negative).
  • Mild-to-moderate COVID-19 was not found to be an independent risk factor for DVT in this cohort.
  • Preoperative leukocyte count and platelet-to-lymphocyte ratio (PLR) were identified as independent risk factors for DVT.

Conclusions:

  • COVID-19 infection, in its mild-to-moderate form, did not significantly elevate the risk of deep vein thrombosis in patients with hip fractures.
  • Standard deep vein thrombosis (DVT) prevention protocols should be consistently applied to all hip fracture patients, regardless of their COVID-19 status.
Abstract

Keywords:
COVID-19Deep vein thrombosisHip fractureRisk factorsSARS-CoV-2

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