Coagulation factor XI (FXI) promotes fibrin formation and inhibits fibrinolysis. Elevated plasma FXI levels, limited to a single measurement, are associated with a higher thrombotic risk. Our case–control study aimed to identify the effect of persistently increased plasma FXI levels on the risk of deep vein thrombosis (DVT). All patients evaluated between January 2016 and January 2018 for a first episode of proximal DVT of the lower extremity were considered for enrolment. Plasma FXI levels were measured at least 1 month after the discontinuation of anticoagulant treatment (T1). The patients with increased plasma FXI levels (>90th percentile of controls) were tested again 3 months later (T2). Among the 200 enrolled patients (M/F 114/86, age range 26–87 years), 47 patients had increased plasma FXI levels at T1 and16 patients had persistently increased plasma FXI levels at T2. The adjusted odds ratio for DVT was 2.4 (95% CI, 1.3 to 5.5, p < 0.001) for patients with increased FXI levels at T1 and 5.2 (95% CI, 2.3 to 13.2, p < 0.001) for patients with persistently high FXI levels at T2. Elevated FXI levels constitute a risk factor for deep vein thrombosis, and this risk nearly doubled in patients with persistently increased plasma FXI levels. Larger prospective studies are needed to confirm our findings.
Several data demonstrated that the incidence of COVID-19 associated-venous thromboembolism (VTE) is high [1][2][3][4]. However, data regarding rates of VTE after discharge for patients hospitalized for COVID-19 are limited and extended out-of-hospital thromboprophylaxis is not routinely recommended, because the risk-benefit remains uncertain [5].We aim to evaluate the rates of patients discharged after COVID-19 infection with or without prescribed thromboprophylaxis; type, dose, and timing of thromboprophylaxis; 30-day clinical outcomes in patients discharged with or without antithrombotic prophylaxis.This was an observational, retrospective singlecenter cohort study. We enrolled all consecutive patients aged ≥ 18 years admitted to the General Internal Medicine Unit of the Padua University Hospital between November 2020 and May 2021 with a diagnosis of acute SARS-CoV2 infection. Exclusion criteria were: ongoing anticoagulant therapy before admission, starting of anticoagulant therapy during hospitalization, inter-or intra-hospital patient transfer before the discharge. Demographics, comorbidities, medications, risk factors for VTE (according to Padua Prediction Score [PPS] and IMPROVE-DD score), Sequential Organ Failure Assessment (SOFA) score, Sepsis-Induced Coagulopathy (SIC) score, and PaO 2 /FIO 2 ratio were collected. Both during hospitalization and at discharge, the antithrombotic regimen (i.e., no thromboprophylaxis, standard dose, or intermediate sub-therapeutic thromboprophylaxis) and * Paolo Simioni
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