Remote history of VTE is associated with severe COVID-19 in middle and older age: UK Biobank cohort study

J Thromb Haemost. 2021 Oct;19(10):2533-2538. doi: 10.1111/jth.15452. Epub 2021 Jul 20.

Abstract

Background: Venous thromboembolism (VTE) is a common, life-threatening complication of COVID-19 infection. COVID-19 risk-prediction models include a history of VTE. However, it is unclear whether remote history (>9 years previously) of VTE also confers increased risk of COVID-19.

Objectives: To investigate possible association between VTE and COVID-19 severity, independent of other risk factors.

Methods: Cohort study of UK Biobank participants recruited between 2006 and 2010. Baseline data, including history of VTE, were linked to COVID-19 test results, COVID-19-related hospital admissions, and COVID-19 deaths. The risk of COVID-19 hospitalization or death was compared for participants with a remote history VTE versus without. Poisson regression models were run univariately then adjusted stepwise for sociodemographic, lifestyle, and comorbid covariates.

Results: After adjustment for sociodemographic and lifestyle confounders and comorbid conditions, remote history of VTE was associated with nonfatal community (RR 1.61, 95% CI 1.02-2.54, p = .039), nonfatal hospitalized (RR 1.52, 95% CI 1.06-2.17, p = .024) and severe (hospitalized or fatal) (RR 1.40, 95% CI 1.04-1.89, p = .025) COVID-19. Associations with remote history of VTE were stronger among men (severe COVID-19: RR 1.68, 95% CI 1.14-2.42, p = .009) than for women (severe COVID-19: RR 1.07, 95% CI 0.66-1.74, p = .786).

Conclusion: Our findings support inclusion of remote history of VTE in COVID-19 risk-prediction scores, and consideration of sex-specific risk scores.

Keywords: COVID-19 severity; DVT; PE; SARS-CoV2 infection; venous thromboembolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biological Specimen Banks
  • COVID-19*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Risk Factors
  • SARS-CoV-2
  • United Kingdom / epidemiology
  • Venous Thromboembolism* / diagnosis
  • Venous Thromboembolism* / epidemiology
  • Venous Thrombosis*