Epidemiology and Predisposing Factors of Post-COVID Venous Thrombosis: A Concise Review

Abstract

Long-coronavirus disease 2019 (COVID-19) represents a heterogeneous clinical syndrome characterized by a pathologic continuum of signs, symptoms, and also laboratory/radiologic abnormalities that may persist for a long time after recovering from an acute severe acute respiratory syndrome-coronavirus disease 2 infection. Among the various components of this postviral condition, the risk of venous thromboembolism in patients hospitalized for COVID-19 remains considerably higher after discharge, especially in older individuals, in men, in patients with longer hospital stays and more aggressive treatment (e.g., mechanical ventilation and/or intensive care), when thromboprophylaxis is not used, and in those with a persistent prothrombotic state. Patients who have these predisposing factors should be monitored more closely to intercept any thrombosis that may occur in a post-COVID time-related manner but may also benefit from extended thromboprophylaxis and/or antiplatelet therapy.

Editorial Compilation—XV

“…Among the various components of this post-viral condition, the risk of venous thromboembolism (VTE) in patients hospitalized for COVID-19 remains considerably higher after discharge, especially in the earlier period (i.e., within the first 6–12 months), in older individuals, in men, in patients with longer hospital stays and more aggressive clinical management (e.g., mechanical ventilation and/or intensive care), when thromboprophylaxis is not used, and in those with a persistent pro-thrombotic state. 4 As also previously noted, STH had previously published COVID-19-related manuscripts in a series of four issues around the broad theme of “maintaining hemostasis and preventing thrombosis in COVID-19,” with the final such issue published in early 2023. 5 As the international emergency for COVID-19 has been withdrawn by the World Health Organization, and we now return to “business as usual,” we are no longer publishing COVID-19 themed issues, and instead any COVID-19-related material accepted for publication will now appear in the other compilation themes in progress, such as this Editorial Compilation series.…”

Editorial Compilation XIV

“…The last review in this issue of STH is by two of the guest editors, Giuseppe Lippi and Emmanuel Favaloro, who provide a concise review on the epidemiology and predisposing factors of post-COVID venous thrombosis. 10 As previously reported, STH has previously published a series of issues around the theme of maintaining hemostasis and preventing thrombosis in COVID-19, with the final such issue published in early 2023. 11 As the international emergency for COVID-19 has been withdrawn by the World Health Organization, and we start to return to “business as usual,” we are no longer publishing COVID-19 themed issues, and instead any COVID-19-related material accepted for publication will now appear in the other compilation themes in progress, such as the Editorial Compilation series ( Table 1 ).…”

Lingering effects of COVID-19 in the care of perioperative patients

“…Clinically, macrovascular and microvascular thrombosis following COVID-19 may affect every organ system, and “thromboinflammation” has been proposed as a unifying mechanism of many lingering sequelae of COVID-19 infection [44 ▪▪ ]. Elevated thrombotic risk has been observed during and after SARS-CoV-2 infection, and across disease severity spectrum [45]. Notably, a case series from Singapore reported severe large vessel ischemic strokes and aortic valve thrombosis in four young and otherwise healthy patients, at a median timepoint of 78 days following COVID-19 diagnosis [46], and multiple observational studies have identified an association between COVID-19 infection and acute limb ischemia [47].…”