COVID-19 confers elevated VTE risk in veterans
Among veterans hospitalized at Veterans Affairs facilities, patients with COVID-19 are at elevated risk for venous thromboembolism, according to a study published in the American Heart Journal.
“This study of patients at U.S. VA hospitals demonstrates that patients hospitalized with COVID-19, despite thromboprophylaxis, are at increased risk for VTE during admission and following discharge,” the researchers wrote.
The elevated risk is “potentially resulting from propagation of a consumptive coagulopathy due to activation of inflammatory pathways or via endotheliitis,” J. Antonio Gutierrez, MD, MHS, assistant professor of medicine at Duke University School of Medicine, and colleagues wrote.
The researchers analyzed 4,461 veterans who tested positive for COVID-19 and 76,929 with negative test results (median age, 68 years; 93% men) who were hospitalized at VA centers from May 1 to Aug. 1, 2020.
Researchers found that among patients with COVID-19, 9.2% had VTE compared with 6.8% of those without COVID-19 (P < .0001).
In patients with no history of VTE, 7.1% of those with COVID-19 experienced VTE compared with 4.6% in those without COVID-19 (P < .0001).
Among patients with COVID-19, 67.2% of VTE events happened during index hospitalization compared with 52.3% of those without COVID-19 (P < .0001).
After propensity score matching, patients with a positive COVID-19 test remained at elevated risk for VTE compared with those without one (HR = 1.28; 95% CI, 1.1-1.48; P = .001).
“This analysis adds to the mounting evidence of increased VTE risk in hospitalized patients with COVID-19 and extends our knowledge to now include increased risk following discharge. Furthermore, these results provide additional justification for future randomized controlled trials studying use of antithrombotics in hospitalized and convalescing patients with COVID-19,” the researchers wrote.