Surgical patients who had COVID-19 more likely to develop fatal blood clots: Study

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Surgical patients who recently contracted a COVID-19 infection are at a higher risk of developing fatal blood clots after surgery, a new study finds.

The global study, conducted by the University of Birmingham and involved 12 hospitals based in the United Arab Emirates, found that patients diagnosed with a current or previous coronavirus infection were more likely to develop postoperative venous thromboembolism (VTE) than those with no history of an infection.

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The research also involved data from 26 hospitals in Saudi Arabia, seven in Kuwait, four in Bahrain, three in Qatar and two in Oman.

“The findings of this new global study, in which the GCC region has played a key role, will help us to understand the impact of COVID-19 and arm us in our collective fight against the pandemic,” said Hayder Saleh Abdulhadi Alsaadi, Adjunctive Clinical Associated Professor at Dubai Medical University and Consultant Orthopaedic, Trauma Surgeon at Rashid Hospital in Dubai.

After collecting and analyzing the data, the researchers found that VTE was independently associated with 30-day mortality, increasing the risk of death by five times within 30 days after surgery in previously infected patients.

Patients hospitalized with COVID-19 have previously been shown to be at a high risk of VTE, between 9 percent and 26 percent, despite the use of preventative drugs, and as high as 31 percent in patients within critical care settings. This study confirms an increased risk in patients hospitalized for surgery as well.

The team is urging surgeons around the world to be on the lookout for VTE by following routine measures to help prevent the condition from occurring.

They can be prevented by using the appropriate drugs when bleeding risk is minimal and by lowering the threshold for diagnostic testing in patients exhibiting signs of VTE.

“Routine postoperative care of surgical patients should include interventions to reduce VTE risk in general, and further research is needed to define the optimal protocols for VTE prevention and treatment for surgical patients in the setting of SARS-CoV-2 infection,” the university statement read.

“People undergoing surgery are already at higher risk of VTE than the general public, but we discovered that a current or recent SARS-CoV-2 infection was associated with greater risk of postoperative VTE,” said one of the study’s co-authors Elizabeth Li, clinical research fellow at the University of Birmingham.

“Most surgical patients have risk factors for VTE, including immobility, surgical wounds and systematic inflammation; the addition of SARS-CoV-2 infection may further increase this risk,” she added.

The team examined data from adult patients aged 18 and above who were undergoing elective or emergency surgery.

“The impact of surgery on coagulation and early reports of increased risk of VTE in COVID-19 patients means there is a need to define VTE risk specifically in patients undergoing surgery. This will help clinicians and policymakers around the world construct future systems of identifying and minimising VTE risk in surgical patients with active or prior SARS-CoV-2 infection,” said co-author Mr. Aneel Bhangu, also from the university.

“Routine postoperative care of surgical patients should include interventions to reduce VTE risk in general, but further research is needed to define the best protocols for VTE prevention and treatment in this setting.”

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