Incidence and determinants of venous thromboembolism over 90 days in hospitalized and nonhospitalized patients with COVID‐19

Abstract

IntroductionCOVID‐19 is associated with an increased risk of venous thromboembolism (VTE), but there is great variation among reported incidence rates. Most previous studies have focused on hospitalized patients with COVID‐19, and only a few reports are from population‐based registries.MethodsWe studied the 90‐day incidence of VTE, associated risk factors and all‐cause mortality in hospitalized and nonhospitalized patients with COVID‐19 in a nationwide cohort. Data on hospitalizations and outpatient visits were extracted from two national registries with mandatory reporting linked by a unique national identification number carried by all Norwegian residents. We performed Cox proportional hazards regression to determine risk factors for VTE after infection with SARS‐CoV‐2.ResultsOur study included 30,495 patients with positive SARS‐CoV‐2 polymerase chain reaction with a mean (SD) age of 41.9 (17.3) years, and 53% were males. Only 2081 (6.8%) were hospitalized. The 90‐day incidence of VTE was 0.3% (95% CI: 0.21–0.33) overall and 2.9% (95% CI: 2.3–3.7) in hospitalized patients. Age (hazard ratio [HR] 1.28 per decade, 95% CI: 1.11–1.48, p < 0.05), history of previous VTE (HR 4.69, 95% CI: 2.34–9.40, p < 0.05), and hospitalization for COVID‐19 (HR 23.83, 95% CI: 13.48–42.13, p < 0.05) were associated with risk of VTE.ConclusionsThe 90‐day incidence of VTE in hospitalized and nonhospitalized patients with COVID‐19 was in the lower end compared with previous reports, with considerably higher rates in hospitalized than nonhospitalized patients. Risk factors for VTE were consistent with previously reported studies.

Thrombo‐inflammatory response in hospitalised patients with COVID‐19: a single institution experience

“…In a study of 287 638 patients hospitalised with COVID‐19 in France in 2020, 5.2% had a concomitant VTE 14 . In a study of 2081 hospitalised patients in Norway in 2020, the 90‐day incidence of VTE was 2.9% 15 . The increased risk of VTE in patients hospitalised with a viral illness is not new.…”

“…Conversely, the recent Omicron VOC has decreased hospitalisation rates 13 . Some studies suggest that the rates of thrombotic events during the COVID‐19 pandemic have declined over time 14,15 . Initial reports from Australia identified a lower mortality and venous thromboembolism (VTE) rate in hospitalised patients with COVID‐19.…”