The purpose of this study is to investigate the prevalence of venous thromboembolism in a regional health care system (Region Östergötland, Sweden) before and during the SARS-COV-2 pandemic. In a retrospective observational study, we will review patient data, diagnostic data and treatment data over a three-month period since the onset of the SARS-COV-2 pandemic. This data will be compared with data from the corresponding time frame during the years 2015 to 2019.
In the current SARS-COV-2 pandemic there is a concern about an increased risk of venous
thromboembolism (VTE) concurrent with the infection, including both pulmonary embolism (PE)
and deep venous thrombosis (DVT) (Klok et al. 2020; Cui et al. 2020; Helms et al. 2020;
Leonard-Lorant et al. 2020; Poissy et al. 2020). International guidelines now recommend
prophylactic anticoagulation for all hospitalized patients with a SARS-COV-2 infection in the
absence of any contraindication (Thachil et al. 2020). The majority of the studies on VTE in
SARS-COV-2 infections have been carried out in the ICU and show prevalence of VTE of between
20 and 30%.(Klok et al. 2020; Cui et al. 2020; Helms et al. 2020). This is a clear increase
compared to the less than 10 % prevalence seen in other ICU patients (Muscedere, Heyland, and
Cook 2007; Deborah Cook et al. 2005; D. Cook et al. 2000). However, a single center study on
consecutive ICU patients with severe sepsis showed a prevalence of VTE of 37% (Kaplan et al.
2015) and another recent publication of patients with severe influenza A/H1N1 infection had a
prevalence of VTE of 44% (Obi et al. 2019).
This raises the question whether the increase in VTE seen in recent publications of
SARS-COV-2 infections is the result of the specific pathophysiology of the virus itself or
the subsequent sepsis with multiorgan failure seen in most complicated and severe cases. The
former would have large implications for patients treated outside the ICU and possibly
outside hospitals (Thachil et al. 2020).
The aim of this study will be to investigate the prevalence of VTE in a regional healthcare
system prior to, and during the SARS-COV-2 pandemic and the differences between ICU,
hospitalized and outpatient cohorts.
Diagnostic Test: Diagnostic examination for venous thromboembolism
Patients who have done a diagnostic examination for suspected VTE (pulmonary embolism och deep venous thrombosis) within the health care system of Region Östergötland. Patients without matching diagnostic examination but with a new diagnosis of pulmonary embolism or deep venous thrombosis during the same time periods will also be taking into account.
Other Name: Array
Inclusion Criteria:
- Any patient that has done a Computer Tomography Angiography of the lungs between 1:st
of March and 31:st of May each year from 2015 to 2020
- Any patient that has done a Ultrasound of the legs between 1:st of March and 31:st of
May each year from 2015 to 2020
- Any patient with a new diagnosis of pulmonary embolism or deep venous thrombosis
between 1:st of March and 31:st of May each year from 2015 to 2020
Exclusion Criteria:
- Incomplete diagnostic examination
- Follow-up examination of know acute VTE
- Primary investigation done outside the healthcare system
- Patient <18 years of age
University Hospital Linköping
Linköping, Östergötland, Sweden