Risk of venous thromboembolism in <scp>COVID‐19</scp> infection

Honkanen, Meeri; Sirkeoja, Simo; Viskari, Hanna; Kailankangas, Ville; Sinisalo, Marjatta; Syrjänen, Jaana

doi:10.1111/imj.16145

Cited by 4 publications

(1 citation statement)

References 11 publications

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“…20 Secondly, pro-inflammatory cytokines release, platelet adhesion and aggregation, endothelial inflammation and injury, thrombin generation caused by SARS-CoV-2 virus infection might lead to immunothrombosis. 21,22 Epidemiologic studies indicated a high incidence of venous thromboembolic events (VTEs), including deep vein thrombosis (DVT) and pulmonary embolism (PE), in patients with COVID-19; [23][24][25] COVID-19 might also be associated with an increased incidence of arterial thrombotic events such as ischemic stroke and limb ischemia, especially in patients with severe COVID-19. [26][27][28] Thirdly, TPO-RA increases platelet production by binding to and activating the thrombopoietin receptor on the membrane of megakaryocytes.…”

Section: Discussionmentioning

confidence: 99%

Can COVID-19 Increase Platelet in Adult Immune Thrombocytopenia During the TPO-RA Administration? A Real-World Observational Study

Wang,

Zhu,

Liu

et al. 2024

JBM

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Introduction: COVID-19 infection has brought new challenges to the treatment of adult patients with immune thrombocytopenia (ITP). In adult ITP patients, there have been no relevant reports exploring the incidence, clinical characteristics, and risk factors of platelet elevation after COVID-19 infection. Materials and Methods: A total of 66 patients with previously diagnosed ITP from December 2022 to February 2023 in a singlecenter were collected and analyzed for this real-world clinical retrospective observational study. Results: In the platelet count increased group (n = 19), 13 patients (68.4%) were using thrombopoietin receptor agonists (TPO-RA) treatment at the time of COVID-19 infection; the median platelet count was 52 (2-207) ×10 9 /L at the last visit before infection and 108 (19-453) ×10 9 /L at the first visit after infection. In the platelet count stable group (n = 19) and platelet count decreased group (n = 28), 9 (47.4%) and 8 (28.6%) patients were using TPO-RA at the time of infection, respectively. ITP patients treated with TPO-RA had a significantly higher risk of increased platelet count than those not treated with TPO-RA at the time of infection (platelet count increased group vs platelet count decreased group: OR: 5.745, p = 0.009; platelet count increased group vs the non-increased group: OR: 3.616, p = 0.031). In the platelet count increased group, the median platelet count at 6 months post-infection was 67 (14-235) × 10 9 /L, which was significantly higher than the platelet level at the last visit before infection (p = 0.040). Conclusion:This study showed that some adult ITP patients had an increase in platelet count after COVID-19 infection, and this phenomenon was strongly associated with the use of TPO-RA at the time of infection. Although no thrombotic events were observed in this study, it reminds clinicians that they should be alert to the possibility of thrombotic events in the long-term management of adult ITP patients during the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Can COVID-19 Increase Platelet in Adult Immune Thrombocytopenia During the TPO-RA Administration? A Real-World Observational Study

Wang,

Zhu,

Liu

et al. 2024

JBM

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Environmental Risk Factors for Cardiovascular Disease in Anesthesiologists and Surgeons in the Operating Room and Intensive Care Unit

Djuric,

Nenadic

2024

Advances in Biochemistry in Health and Disease

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Causal relationships between COVID-19 and venous thromboembolism: A mendelian randomization analysis

Wang,

Wu,

Pan

et al. 2024

Phlebology

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Objective: Observational studies show the correlation between COVID-19 and venous thromboembolism (VTE) risk. However, the causal effects remain uncertain. We aimed to explore the potential causal association between COVID-19 and VTE using Mendelian randomization (MR) design. Methods: Two-sample MR was used to evaluate the potential causality between COVID-19 and VTE by selecting single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) from genome-wide association studies (GWAS). The weighted median, MR-Egger, simple mode, and weighted mode were employed as supplementary methods for MR estimations, with the inverse-variance weighted (IVW) method serving as the principal analysis. In addition, we took sensitivity analyses, including Cochran’s test, MR-Pleiotropy Residual Sum and Outlier (MR-PRESSO), and leave-one-out analysis to ensure that we obtained stable and reliable results. Results: Our study selected 26 COVID-19 severity, 31 COVID-19 hospitalization, and 13 COVID-19 susceptibility SNPs as instrumental variables. The IVW analysis results revealed that there was no causal relationship between COVID-19 severity, hospitalization, or susceptibility and VTE, with odds ratios of 0.974 (95%CI: 0.936-1.013, p = 0.19), 0.976 (95%CI: 0.918-1.039, p = 0.447), and 0.908 (95%CI: 0.775-1.065, p = 0.235), respectively. The IVW approach yielded consistent results with MR-Egger, Weighted Median simple mode, and weighted mode. MR-PRESSO and sensitivity analysis further confirmed the stability and consistency of the MR results. Conclusions: This study did not find evidence to support a causal relationship between COVID-19 and VTE at the genetic level. Further investigation is warranted to determine if the significant association reported in previous observational studies between the two is due to confounding factors.

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Risk of venous thromboembolism in COVID‐19 infection

Cited by 4 publications

References 11 publications

Can COVID-19 Increase Platelet in Adult Immune Thrombocytopenia During the TPO-RA Administration? A Real-World Observational Study

Can COVID-19 Increase Platelet in Adult Immune Thrombocytopenia During the TPO-RA Administration? A Real-World Observational Study

Environmental Risk Factors for Cardiovascular Disease in Anesthesiologists and Surgeons in the Operating Room and Intensive Care Unit

Causal relationships between COVID-19 and venous thromboembolism: A mendelian randomization analysis

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