Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales

The study titled “Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales” provides significant insights into the relationship between COVID-19 and the incidence of vascular diseases.

Here is a detailed summary:

Background

  • Objective: To determine the long-term effects of COVID-19 on the incidence of vascular diseases.
  • Methods: The study analyzed anonymized health records from England and Wales, comparing the incidence of arterial thromboses and venous thromboembolic events (VTEs) in people with and without a COVID-19 diagnosis.

Key Results

  1. Population and COVID-19 Diagnoses:
    • Involved 48 million adults, with 125,985 hospitalized and 1,319,789 non-hospitalized within 28 days of COVID-19 diagnosis.
    • The risk of non-hospitalized COVID-19 was higher in women, while hospitalized COVID-19 risk was higher in men. Risk increased with age and deprivation​​.
  2. Incidence of Vascular Diseases:
    • There were 260,279 first arterial thromboses and 59,421 first VTEs during the study period.
    • Adjusted hazard ratios (aHRs) for arterial thrombosis and VTEs were significantly higher soon after COVID-19 diagnosis but declined over time​​.
  3. Comparison with Non-COVID-19 Cases:
    • In the first week after COVID-19 diagnosis, aHRs were 21.7 for arterial thrombosis and 33.2 for VTEs, compared to non-COVID-19 cases.
    • These ratios declined to 1.34 for arterial thrombosis and 1.80 for VTEs by weeks 27 to 49​​.
  4. Subgroup Analysis:
    • Higher aHRs were observed longer after diagnosis in hospitalized vs. non-hospitalized COVID-19 cases.
    • Black or Asian individuals and those without prior events had higher aHRs compared to White individuals or those with prior events​​.
  5. Clinical Implications:
    • The study highlights the need for strategies to prevent vascular events post-COVID-19, especially after severe cases leading to hospitalization.
    • Emphasizes the importance of early primary care review, risk factor management, and adherence to preventive therapies​​.

Significance

  • Implications: The study underscores the elevated risk of arterial and venous thrombotic diseases following COVID-19, particularly in hospitalized patients and certain demographic groups.
  • Prevention and Care: These findings support the use of COVID-19 vaccines, early review after discharge, and secondary preventive measures in high-risk patients​​.

Conclusion

This comprehensive analysis reveals a significant association between COVID-19 and an increased risk of major arterial and venous thrombotic diseases. It calls for vigilant post-COVID-19 monitoring and proactive management strategies to mitigate these risks.

Read More: https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.122.060785

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