Venous thromboembolism in non-COVID-19 population during the pandemic: a nationwide multicenter retrospective survey

Abstract

Impact of pandemic on the incidence of venous thromboembolism (VTE) in non-COVID-19 patients is undetermined. Thus, a nationwide multicenter retrospective survey was conducted to evaluate the disease burden in non-COVID-19 population. This multi-center survey involved 94 hospitals from 24 provinces in the mainland of China, and collected data on non-COVID-19 patients admitted to the radiology departments due to VTE between January 24 and April 16, 2020. Baseline characteristics, VTE risk factors, clinical manifestations and the treatments were compared with those in the same period of 2019. 3,358 patients with VTE from 74 hospitals were included in this study (1,458 in 2020, 1,900 in 2019). Most aged ≥ 50 years (80.6% in the pandemic, 81.2% in 2019). The number of patients aged 30-39 years increased from 3.9% in 2019 period to 5.8% in the pandemic (p = 0.009). Among the VTE risk factors, the rate of decreased activity increased significantly in the pandemic, and was much higher than that in 2019 (30.7% vs 22.6%, p < 0.0001). Under the risk of decreased activity, patients with comorbidities chronic diseases, especially diabetes, showed significantly a higher incidence of VTE (30.4% vs 22.0%, p < 0.0001). In the pandemic period, fewer patients were treated with anticoagulation alone (33.5% vs 36.7%, p = 0.05), and more underwent inferior vena cava filter (IVCF) implantation, compared with those in 2019 (66.5% vs 63.2%, p = 0.046). The pandemic increased the VTE risk of decreased activity among the non-COVID-19 population. Patients with comorbidities, especially diabetes, have a significant higher risk of VTE during the pandemic. Keywords Coronavirus disease 2019 • Venous thromboembolism • Non-COVID-19 population • Risk factors • Decreased activity Highlights• The pandemic affected the risk factors of venous thromboembolism (VTE).• Decreased activity is the leading VTE risk factor among the non-COVID-19 population. • Patients with comorbidities, especially diabetes, showed a significant higher risk of VTE.

COVID-19 pandemic affects the ability of negative D-dimer to identify venous thromboembolism patients at low risk of recurrence: insights from the Apidulcis study

“…It is well known that the COVID-19 pandemic is associated with an increased rate of VTE events, which is not limited to patients who are more seriously affected. 5 , 6 Furthermore, an impact of the pandemic on increasing VTE occurrence has been described even in COVID-19-negative populations, 7 , 8 likely due to indirect effects of the pandemic, such as the various restrictions and the lockdown, resulting in a general reduction in physical activity, 9 a subsequent trend to obesity, and -among others - an increase in smoking. 10 The present data suggest that the pandemic may have influenced the Apidulcis study results.…”