2022 VTE - ACEP Now

Studies from the COVID-19 pandemic have shown an increased risk of venous thromboembolism (VTE) in patients infected with SARS-CoV-2, including both pulmonary embolism and deep venous thrombosis. However, the risk of VTE and its prevalence in outpatients with COVID-19 has been less studied than in hospitalized patients.

A recent study of 8,700 patients, “Risk of Venous Thromboembolism in a Swedish Healthcare System during the COVID-19 Pandemic: A Retrospective Cross-sectional Study,” provides insight on how this might affect workup of potential VTE in patients positive for SARS-CoV-2.

Which of the following is NOT a true finding or important consideration to weigh when interpreting the study?

A) The overall percentage of patients who achieved effective bleeding hemostasis after receiving reversal agents was 78.5%; it was similar among the different reversal agents.

B) The overall risk of mortality from severe bleeding from a DOAC-related event was 17.7% in this analysis, with slightly higher rates in patients with intracranial bleeds.

C) Not achieving bleeding homeostasis was strongly associated with a more than three-fold increase in the risk of death. Approximately half of patients with severe DOAC-related bleeding suffered from long-term moderate to severe disability. Therefore, clinicians should consider additional reversal attempts or other treatment modalities for patients whose bleeding is still uncontrolled.

D) Bleeding-related morbidity and mortality among patients with atrial fibrillation on DOACs is greater than the morbidity and mortality from patients with atrial fibrillation who are undertreated in terms of ischemic stroke prevention.

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