P149 | Acute and long-term management of venous thromboembolism through the post-COVID-19 pandemic era
M.A. Wu1, A. Taino1, P. Facchinetti1, V. Rossi1, S. Berra2, R. Celano1, F. Urso1, A. Meschia1, R. Colombo3 | 1Division of Internal Medicine, Luigi Sacco Hospital, University of Milan, 2Department of Biomedical and Clinical Sciences, University of Milan, 3Division of Anesthesiology and Intensive Care, Luigi Sacco Hospital, University of Milan, Italy
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Background and Aim: COVID-19 increases the risk of venous thromboembolism (VTE) through a complex interplay of mechanisms collectively termed immunothrombosis. Limited data exist on VTE challenges in the acute setting throughout a dynamic long-term follow-up compared to non-COVID-19 patients. This study aimed to investigate acute and long-term management and complications in VTE patients with and without COVID-19.
Materials and Methods: Prospective, observational, single-center cohort study on VTE patients followed from acute care until 24 months post-diagnosis.
Results: 157 patients, 30 with COVID-19-associated VTE and 127 unrelated to COVID-19, were enrolled. The mean follow-up was 10.8 (±8.9) months. Baseline characteristics were similar, but COVID-19 patients had fewer comorbidities (1.3±1.29 vs. 2.26±1.68, p<0.001) and a lower probability of remaining on anticoagulant therapy after three months (p<0.003). The most used initial therapy was low molecular weight heparin in 130/157 cases, followed by long-term therapy with direct oral anticoagulants in 123/157. Two (6.7%) COVID-19 vs. three (2.4%) non-COVID-19 patients (p=0.243) had major hemorrhagic events. All hemorrhagic events occurred within the first three months. Three non-COVID-19 patients developed chronic thromboembolic pulmonary hypertension. Mortality was 0% in patients with COVID-19 compared to 9.4% in the non-COVID-19 subgroup (p=0.027).
Conclusions: Our study underscores the evolving nature of VTE management, emphasizing the importance of personalized risk-based approaches.
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