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    Oral Communication

    COVID

    Clinical Outcomes in COVID-19

    OC 29.1 - Long-term outcomes of COVID-19 associated venous thromboembolism (VTE)

    Sunday, June 25, 2023
    14:45 – 15:00 ET
    Room: 710A
    Session Available As: On-Demand

      Presenting Author(s)

    • Walter Ageno, MD (he/him/his)

      Professor of Medicine
      Department of Medicine and Surgery, University of Insubria, Varese, Italy
      Varese, Lombardia, Italy

      • Co-Author(s)

    • EA

      Emilia Antonucci

      Researcher
      Fondazione Arianna
      Bologna, Emilia-Romagna, Italy

    • DP

      Daniela Poli

      Medical Doctor
      SOD Malattie Aterotrombotiche, Azienda Ospedaliera Universitaria Careggi
      Firenze, Toscana, Italy

    • EB

      Eugenio Bucherini

      Physician
      AUSL Romagna
      Faenza, Emilia-Romagna, Italy

    • AC

      Antonio Chistolini

      Director
      Dipartimento di Medicina Traslazionale e di Precisione Sapienza Università di Roma
      Roma, Lazio, Italy

    • VF

      Vittorio Fregoni

      Medical Doctor
      U.O.C. Medicina Generale, Ospedale di Sondalo, ASST della Valtellina e dell'Alto Lario, Sondalo
      Sondalo, Lombardia, Italy

    • TL

      Teresa Lerede

      Medical Doctor
      Divisione di Immunoematologia e Medicina Trasfusionale & Centro Emostasi e Trombosi, ASST Papa Giovanni XXIII
      Bergamo, Lombardia, Italy

    • RP

      Roberta Pancani

      Medical Doctor
      U.O. Pneumologia, Dipartimento Cardiotoraco-Vascolare, Azienda Ospedaliero-Universitaria Pisana, Ospedale di Cisanello
      Pisa, Toscana, Italy

    • SP

      Simona Pedrini

      Medical Doctor
      Centro Trombosi, UO laboratorio Analisi, Fondazione Poliambulanza
      Brescia, Lombardia, Italy

    • FP

      Filippo Pieralli

      Director
      Dipartimento Emergenza Accettazione/Subintensiva di Medicina, AOU Careggi,
      Firenze, Toscana, Italy

    • Pasquale Pignatelli, PhD

      Professor
      Dept. of Clinical, Internistic, Anesthesiologic and Cardiovascular Sciences, Sapienza University
      Roma, Lazio, Italy

    • AP

      Attilia Pizzini

      Medical Doctor
      Centro Emostasi Trombosi Ospedale Maggiore
      Bologna, Emilia-Romagna, Italy

    • GP

      Gianmarco Podda

      Head
      Medicina 3, ASST Santi Paolo e Carlo, San Paolo
      Milano, Lombardia, Italy

    • NP

      Nicola Potere

      Medical Doctor
      Dipartimento di Medicina e Scienze dell’invecchiamento, Università G. D’Annunzio
      Chieti, Abruzzi, Italy

    • LS

      Luca Sarti

      Medical Doctor
      Centro per la diagnosi e la sorveglianza della malattia tromboembolica, UO Medicina interna d'urgenza, Azienda Ospedaliero Universitaria Policlinico di Modena, Ospedale Civile Baggiovara
      Modena, Emilia-Romagna, Italy

    • ST

      Sophie Testa

      Head
      Centro Emostasi e Trombosi, ASST Cremona
      Cremona, Lombardia, Italy

    • AV

      Adriana Visonà

      Head
      UOC Angiologia - Dipartimento di Medicina Clinica - Azienda ULSS 2 Marca Trevigiana - Ospedale San Giacomo Apostolo
      Castelfranco Veneto, Veneto, Italy

    • GP

      Gualtiero Palareti

      Professor
      Arianna Foundation on Anticoagulation
      Bologna, Emilia-Romagna, Italy

    Background: Little information is available on long-term outcomes of venous thromboembolism (VTE) associated with COVID-19 infection after discontinuation of anticoagulant treatment.

    Aims: To compare baseline characteristics, management strategies, and long-term clinical outcomes between patients with COVID-19 associated VTE and patients with VTE provoked by hospitalization for other acute medical illnesses.

    Methods: We prospectively enrolled a cohort of patients with COVID-19 associated VTE diagnosed between June 2020 and December 2021 and followed-up these patients for a minimum of 12 months after treatment discontinuation. We then identified a control cohort using the database of an ongoing registry, the START2 register, selecting patients without COVID-19 who developed VTE secondary to hospitalization before February 2020 and had a minimum follow-up of 12 months after treatment discontinuation. Exclusion criteria included age < 18 years, other indications to anticoagulant treatment, active cancer, recent ( < 3 months) major surgery, trauma, pregnancy, participation in interventional studies. Primary endpoint was the occurrence of venous and arterial thrombotic events.

    Results: We enrolled 278 patients with VTE secondary to COVID-19 (median age 64 years, 69.4 males) and 300 controls (median age 69 years, 54.7 males). COVID-19 patients had more frequently PE without DVT than controls (83.1% vs 46.2%, p< 0.001) and a lower prevalence of chronic inflammatory disease (1.4% and 16.3%,p < 0.001) and history of VTE (5.0% and 19.0%, p< 0.001). The median duration of anticoagulant treatment (194 and 225 days, p=n.s.) and the proportion of patients who discontinued anticoagulation (78.0% and 75.0%, p=n.s.) were similar between the two groups. Thrombotic event rates after discontinuation were 1.5 and 2.6 per 100 patient-years, respectively (p=n.s.)(Figure).

    Conclusion(s): Patients with COVID-19 associated VTE are at low risk of recurrent thrombotic events after treatment discontinuation. This risk is similar to the risk observed in patients with VTE secondary to hospitalization for other medical diseases.

    Learning Objectives:

    • Upon completion, participants will be able to assess the risk of recurrence in patients with COVID-19 associated venous thromboembolism
    • Upon completion, participants will be able to assess the risk of bleeding in patients with COVID-19 associated venous thromboembolism receiving anticoagulant drugs
    • Upon completion, participants will be able to define the optimal duration of anticoagulant treatment for patients with COVID-19 associated venous thromboembolism