Authors

• Ana Marija Slišković — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0001-6622-7572
• Mislav Puljević — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0003-1477-2581
• Ana Šutalo — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0002-7644-6362
• Ante Bosnić — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0003-4019-3874
• Ljiljana Banfić — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0002-4538-8980
• Majda Vrkić Kirhmajer — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0002-1340-1917

Abstract

**Background**: In March 2020 formally declared pandemic of coronavirus disease (COVID-19) caused a global impact on public health. Venous thromboembolism (VTE) encompassing pulmonary embolism (PE) and deep venous thrombosis (DVT) is frequently observed in patients with COVID-19 (1), while the pandemic influence on non COVID-19 VTE prevalence remains unknown. Previous meta -analysis supported an association between regular physical activity and lower risk of VTE when compared with a sedentary or less active lifestyle (2). Aim: to investigate the influence of pandemic circumstances on the prevalence of non COVID-19 patients hospitalized due to VTE. **Patients and Methods**: Single centre retrospective analysis of consecutive non COVID-19 patients admitted for VTE was performed. We compared demographic characteristics and diagnostics findings in patients hospitalized for VTE between 1st of March and 31st of October 2019 and non COVID-19 VTE patients hospitalized between the same period in 2020. All patients underwent laboratory tests, venous ultrasonography of the lower limbs and/or CT pulmonary angiography and had negative swab test for SARS-CoV2 at admission. One patient had previously recovered from COVID-19. **Results**: During the period of 8 months 70 VTE patients (female 48%, mean age 60.8 ± 17.2 years) were admitted in 2019, while 86 non COVID-19 VTE patients (female 50%, mean age 68.5± 16.8 years) were admitted in 2020. There was no significant difference in prevalence of VTE hospitalization (4.1% vs 5.4%, p=0.106), but patients in 2020 were significantly older (p=0.002). Dividing the VTE cases into isolated PE, isolated DVT and combined DVT+PE we found a significant increase in prevalence of DVT+PE during pandemic (34 vs 36, p=0.23; 23 vs 25, p=0.24 and 13 vs 25, p=0.03, respectively). **Conclusion**: During COVID 19 pandemic we observed significant increase in prevalence of hospitalized non COVID-19 patients with combined DVT+ PE but not with isolated PE or isolated DVT. Possible explanation could be a less active lifestyle due to pandemic social restriction recommendation and delaying treatment for initial DVT.

Keywords

venous thromboembolism, non COVID-19 patients, SARS-CoV-2 outbreak

DOI

Literature

1. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al. Endorsed by the ISTH, NATF, ESVM, and the IUA, Supported by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 June 16;75(23):2950–73. https://doi.org/10.1016/j.jacc.2020.04.031
2. Kunutsor SK, Mäkikallio TH, Seidu S, de Araújo CGS, Dey RS, Blom AW, et al. Physical activity and risk of venous thromboembolism: systematic review and meta-analysis of prospective cohort studies. Eur J Epidemiol. 2020 May;35(5):431–42. https://doi.org/10.1007/s10654-019-00579-2