Increased Bleeding Risk in Patients with Prior Pulmonary Embolism - EMJ

Increased Bleeding Risk in Patients with COVID-19 with Prior Pulmonary Embolism: Late-Breaking Abstract From ATS 2024

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A RECENT multicenter study led by Li et al. has uncovered critical insights into the risks faced by patients with a history of acute pulmonary embolism (PE) during the COVID-19 pandemic. Conducted across seven teaching hospitals in mainland China, this study reveals that COVID-19 significantly elevates the risk of bleeding in these patients, particularly those on anticoagulant therapy. The results of this study were presented at ATS 2024 International Conference.

Between January 1, 2016, and November 1, 2022, over 1000 patients diagnosed with acute PE were tracked. Data collected during the Omicron variant surge from December 1, 2022, to June 1, 2023, showed that 67.2% of these patients contracted COVID-19. Of these, 47.8% were on anticoagulants. This contrasts with 55.9% of non-COVID PE patients who were also on anticoagulants.

Alarmingly, the study found that COVID-19 patients on anticoagulation had a 10.5% risk of bleeding compared to just 2.1% in their non-COVID counterparts. The adjusted odds ratio for bleeding in these patients was 4.75, indicating a significantly higher risk. Additionally, 29.1% of the COVID-19 cohort experienced long COVID, which was associated with a higher and delayed risk of both bleeding and venous thromboembolism (VTE) recurrence.

These findings highlight the critical need for meticulous management of anticoagulation in PE patients who contract COVID-19, particularly, those with long COVID require close monitoring to prevent severe complications. Adjustments to treatment protocols to mitigate bleeding risks while preventing thromboembolic events may be required.



Li et al. Outcomes of COVID-19 in Patients With Prior Acute Pulmonary Embolism, A Multicenter Cohort Study. P658. American Thoracic Society Annual Meeting 2024.

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