• Pablo Demelo-Rodríguez, Lucía Ordieres-Ortega, Zichen Ji, Jorge Del Toro-Cervera, Javier de Miguel-Díez, Luis A Álvarez-Sala-Walther, and Francisco Galeano-Valle.
• Venous Thromboembolism Unit, Internal Medicine, Hospital General Universitario Gregorio Marañon, Madrid, Spain.
• Eur. J. Haematol. 2021 May 1; 106 (5): 716-723.

IntroductionCOVID-19 predisposes patients to a higher risk of venous thromboembolism (VTE), although the extent of these implications is unclear and the risk of bleeding has been poorly evaluated. To date, no studies have reported long-term outcomes of patients with COVID-19 and VTE.MethodProspective observational study to evaluate long-term (90 days or more) outcomes of patients diagnosed with VTE (PE, DVT of the extremities, or both) in the setting of COVID-19. The main outcome of the study was a compound of major bleeding and death.ResultsThe study comprised 100 patients (mean age 65 ± 13.9 years). At the time of VTE diagnosis, 66% patients were hospitalized, 34.8% of them in the ICU. Mean follow-up was 97.9 ± 23.3 days. During the study period, 24% patients died and median time to death was 12 (IQR: 2.25-20.75) days, 11% patients had major bleeding and median time to event was 12 (IQR: 5-16) days. The cause of death was PE in 5% and bleeding in 2% of patients. There were no VTE recurrences. The main study outcome occurred in 29% patients. Risk of death or major bleeding was independently associated with ICU admission (HR 12.2; 95% CI 3.0-48.3), thrombocytopenia (HR 4.5; 95% CI 1.2-16.5), and cancer (HR 21.6; 95% CI 1.8-259).ConclusionIn patients with COVID-19 and VTE, mortality and major bleeding were high and almost a third of deaths were VTE-related. The majority of complications occurred in the first 30 days. ICU admission, thrombocytopenia, and cancer are risk factors for poor prognosis.© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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