Link Between COVID-19 and Deep Vein Thrombosis Risk

Patients admitted to general wards suffered venous thromboembolism (VTE) in 8% of the cases. The study findings underline the high risk of VTE in COVID-19 patients.

In hospitalized patients with COVID-19 the risk of deep vein thrombosis is 14%, revealed review of the worldwide published data on "Venous thromboembolism (VTE) in COVID-19 patients", Cihan Ay, Stephan Nopp, and Florian Moik from the Department of //Medicine I, Clinical Division of Haematology and Haemostaseology, now for the first time, provide an in-depth analysis on the risk of VTE in patients hospitalised for COVID-19.

While hospitalized patients at general wards have a VTE risk between 5 and 11%, the risk of developing deep vein thrombosis or pulmonary embolism in critically ill patients is 18 to 28%.

Deep Vein Thrombosis (DVT) - Causes - Symptoms - Diagnosis - Treatment - Complications - Prevention
A blood clot (thrombus) in the deep venous system of the leg leads to deep vein thrombosis (DVT). DVT is a major cause of morbidity and mortality.

‘Patients admitted to general wards suffered venous thromboembolism (VTE) in 8% of the cases. The study findings underline the high risk of VTE in COVID-19 patients.’

"From the beginning of the COVID-19 pandemic, studies reported an increased rate of thrombosis and pulmonary embolism in patients with COVID-19. On the basis of these reports, but without robust evidence from controlled interventional studies, global treatment strategies were developed, recommending more intense thromboprophylaxis strategies. Our study now offers a better understanding of the underlying risk and, therefore, aids in individual treatment decisions based on accurate risk assessment for the different patient groups," reports Principal Investigator Cihan Ay.

Within their review of the literature, the authors assessed a total of 5,951 studies published in the field of VTE in COVID-19. Of those, 86 studies were found eligible for inclusion and reported rates of thrombosis and pulmonary embolism in COVID-19 patients. After excluding additional studies due to underlying risk of bias in a structured assessment, 66 studies (28,173 patients) were found eligible to perform a meta-analysis to provide a robust estimate on risk of VTE in COVID-19.

Further, high heterogeneity in VTE rates was found between different patient subgroups. The rate was highest in patients admitted to intensive care units, with 23% of patients suffering VTE.

Coronavirus
Coronaviruses infect animals, humans, and birds. Human coronaviruses, such as SARS, MERS, and 2019-nCoV cause respiratory distress and even death. The S protein is the infectious agent of the virus.

In addition, the authors specifically focused on estimating the risk of potentially life-threatening pulmonary embolism. The result: "This risk is considerably higher than in other comparable serious medical illnesses and ranges between 10 and 18% in COVID-19 patients requiring intensive care. Further, astonishingly, deep vein thrombosis was detected in almost half of the hospitalised COVID-19 patients who had been systematically screened for thrombosis using ultrasound."

These findings underscore the strong impact of COVID-19 on the blood-clotting system. In addition, an exploratory analysis revealed that patients who developed deep vein thrombosis or pulmonary embolism during hospitalization had significantly higher D-dimer concentrations at admission, a laboratory parameter that indicates an activated coagulation system. This finding might be used to help develop personalized, risk-stratified thromboprophylaxis strategies in the future.

Quiz on Deep Vein Thrombosis
Did you know that prolonged sitting can cause a blood clot? Or if that clot stuck in the lungs death ensues? Learn more about deep vein thrombosis from this quiz.

In summary, the authors provide a detailed evaluation of the risk of VTE based on the severity of the disease. Future studies need to determine whether elevated D-dimer at hospital admission justifies intensification of anticoagulant treatment in hospitalized patients with COVID-19.

Source-Eurekalert

Deep Vein Thrombosis: Fresh Insights
Patients who received immediate compression therapy were 20 percent less likely to develop residual vein occlusion and 8 percent less likely to suffer post thrombotic syndrome compared with those who did not receive immediate compression.