Publication date: Jul 03, 2025
Venous thromboembolism (VTE) is a recognized complication of SARS-CoV-2 infection, but its clinical features and both sort- and long-term outcomes remain incompletely characterized. We aimed to compare the clinical profile and outcomes of patients with VTE with and without recent COVID-19. We conducted a prospective cohort study including 2012 patients with objectively confirmed VTE. COVID-19-associated VTE was defined as VTE diagnosed within 30 days of a microbiologically confirmed SARS-CoV-2 infection. Clinical characteristics, treatment, and outcomes were compared between groups. Propensity score matching (1:1) and competing risk models were used to adjust for confounding. The primary outcomes-assessed at both 30 days and 365 days-included all-cause mortality, major bleeding, and VTE recurrence. A total of 272 patients (13. 5%) had COVID-19-associated VTE. Compared with non-COVID cases, these patients more often had pulmonary embolism, higher D-dimer levels, and greater use of unfractionated heparin. At 30 days, COVID-19 was associated with increased mortality (HR 2. 29; 95% CI 1. 19-4. 40) and major bleeding (HR 2. 11; 95% CI 1. 06-4. 21). At one year, the bleeding risk remained higher (HR 1. 54; 95% CI 1. 02-2. 33), while VTE recurrence was lower (HR 0. 34; 95% CI 0. 13-0. 94). These results were consistent after propensity score matching. COVID-19-associated VTE is linked to worse short-term outcomes, including early mortality and bleeding, and to a persistently elevated bleeding risk at one year. Lower recurrence rates support the consideration of COVID-19 as a transient provoking factor.
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| Concepts | Keywords |
|---|---|
| 30days | Anticoagulation |
| Competing | COVID-19 |
| Covid | Deep vein thrombosis |
| Microbiologically | Pulmonary embolism |
| Thromboembolism | Venous thromboembolism |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| disease | MESH | venous thromboembolism |
| pathway | REACTOME | SARS-CoV-2 Infection |
| disease | MESH | bleeding |
| disease | MESH | recurrence |
| disease | MESH | pulmonary embolism |
| drug | DRUGBANK | Heparin |
| disease | MESH | Long Covid |
| disease | MESH | Emergency |
| disease | MESH | Deep vein thrombosis |
| disease | MESH | stroke |
| disease | MESH | men 3 |
| disease | MESH | critically ill |
| disease | MESH | inflammation |
| pathway | KEGG | Platelet activation |
| disease | MESH | viral infection |
| disease | MESH | complications |
| disease | MESH | infection |
| disease | MESH | thrombosis |
| disease | MESH | death |
| drug | DRUGBANK | Oxygen |
| disease | MESH | dyspnea |
| disease | MESH | cancer |
| disease | MESH | immobilization |
| disease | MESH | tic |
| disease | IDO | blood |
| disease | MESH | compartment syndrome |
| drug | DRUGBANK | Coenzyme M |
| disease | IDO | algorithm |