tetano
Editor, Senior Moderator
J Am Coll Emerg Physicians Open
. 2021 Sep 1;2(5):e12530.
doi: 10.1002/emp2.12530. eCollection 2021 Oct.
Risk of venous thromboembolism in a Swedish healthcare system during the COVID-19 pandemic: A retrospective cross-sectional study
Jens Wretborn[SUP] 1 [/SUP], Matthias Jörg[SUP] 1 [/SUP], Patrik Benjaminsson Nyberg[SUP] 1 [/SUP], Daniel B Wilhelms[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: The objective of this study was to investigate the risk and prevalence of venous thromboembolism (VTE) for patients undergoing a diagnostic test for VTE with confirmed COVID-19 infection compared with patients with no COVID-19 infection.
Methods: This was a retrospective cross-sectional study of patients in an integrated healthcare system in Sweden, covering a population of 465,000, with a diagnostic test for VTE between March 1 and May 31 in the years 2015 to 2020. Risk for VTE with COVID-19 was assessed by logistic regression, adjusting for baseline risk factors.
Results: A total of 8702 patients were included, and 88 of those patients tested positive on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction test. A positive SARS-CoV-2 test did not increase the odds for VTE (odds ratio, 0.97; 95% confidence interval [CI], 0.55-1.74) and did not change when adjusting for sex, previous VTE, previous malignancy, Charlson score, hospital admission, intensive care, or ongoing treatment with anticoagulation (odds ratio, 0.72; 95% CI, 0.16-3.3). The prevalence of VTE was unchanged in 2020 compared with 2015 to 2019 (16.5% vs 16.1%, respectively), and there was no difference in VTE between the SARS-CoV-2 positive, negative, or untested groups in 2020 (15.9%, 17.6%, and 15.7%, respectively; P = 0.85).
Conclusions: We found no increased prevalence of VTE in the general population compared with previous years and no increased risk of VTE in patients who were SARS-CoV-2 positive, suggesting that SARS-CoV-2 status should not influence VTE workup in the emergency department. The prevalence of VTE was high in patients with SARS-CoV-2 treated in the intensive care unit (ICU), where the suspicion for VTE should remain high.
Keywords: SARS‐CoV‐2; deep venous thrombosis; emergency department; prevalence; pulmonary embolism; venous thromboembolism.
. 2021 Sep 1;2(5):e12530.
doi: 10.1002/emp2.12530. eCollection 2021 Oct.
Risk of venous thromboembolism in a Swedish healthcare system during the COVID-19 pandemic: A retrospective cross-sectional study
Jens Wretborn[SUP] 1 [/SUP], Matthias Jörg[SUP] 1 [/SUP], Patrik Benjaminsson Nyberg[SUP] 1 [/SUP], Daniel B Wilhelms[SUP] 2 [/SUP]
Affiliations
- PMID: 34485977
- PMCID: PMC8410024
- DOI: 10.1002/emp2.12530
Abstract
Objective: The objective of this study was to investigate the risk and prevalence of venous thromboembolism (VTE) for patients undergoing a diagnostic test for VTE with confirmed COVID-19 infection compared with patients with no COVID-19 infection.
Methods: This was a retrospective cross-sectional study of patients in an integrated healthcare system in Sweden, covering a population of 465,000, with a diagnostic test for VTE between March 1 and May 31 in the years 2015 to 2020. Risk for VTE with COVID-19 was assessed by logistic regression, adjusting for baseline risk factors.
Results: A total of 8702 patients were included, and 88 of those patients tested positive on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction test. A positive SARS-CoV-2 test did not increase the odds for VTE (odds ratio, 0.97; 95% confidence interval [CI], 0.55-1.74) and did not change when adjusting for sex, previous VTE, previous malignancy, Charlson score, hospital admission, intensive care, or ongoing treatment with anticoagulation (odds ratio, 0.72; 95% CI, 0.16-3.3). The prevalence of VTE was unchanged in 2020 compared with 2015 to 2019 (16.5% vs 16.1%, respectively), and there was no difference in VTE between the SARS-CoV-2 positive, negative, or untested groups in 2020 (15.9%, 17.6%, and 15.7%, respectively; P = 0.85).
Conclusions: We found no increased prevalence of VTE in the general population compared with previous years and no increased risk of VTE in patients who were SARS-CoV-2 positive, suggesting that SARS-CoV-2 status should not influence VTE workup in the emergency department. The prevalence of VTE was high in patients with SARS-CoV-2 treated in the intensive care unit (ICU), where the suspicion for VTE should remain high.
Keywords: SARS‐CoV‐2; deep venous thrombosis; emergency department; prevalence; pulmonary embolism; venous thromboembolism.