SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

COVIDSurg Collaborative; GlobalSurg Collaborative; Alexis P  Arnaud; José  Azevedo; Ana Maria  Minaya Bravo; Daoud Chaudhry; Ehab  AlAmeer; Kariem  El-Boghdadly; Muhammed  Elhadi; Sameh  Emile; Gaetano  Gallo; James C. Glasbey; Dhruva  Ghosh; Arda Isik; Conor S  Jones; Sezai   Leventoğlu; Elizabeth Li; Janet  Martin; Helen M. Mohan; Dmitri Nepogodiev; Pranay Pawar; Neil J. Smart; Peter Pockney; Joana F.F. Simoes; Stephen  Tabiri; Mary L. Venn; Deborah Wright; Aneel  Bhangu; Waheed-Ul-Rahman  Ahmed; Leah  Argus; Alasdair  Ball; Edward P  Bywater; Ruth  Blanco-Colino; Amanpreet  Brar; Brett E  Dawson; Irani  Duran; Rohan R. Gujjuri; Ewen M  Harrison; Sivesh K Kamarajah; James M  Keatley; Samuel  Lawday; Harvinder  Mann; Ella J  Marson; Kenneth A  Mclean; Lisa  Norman; Riinu  Ots; Oumaima  Outani; Maria  Picciochi; Irène  Santos; Catherine  Shaw; Elliott H  Taylor; Isobel M  Trout; Chris Varghese; William  Xu; Irida  Dajti; Arben  Gjata; Salah Eddine Oussama Kacimi Oussama Kacimi; Luis  Boccalatte; Maria Marta  Modolo; Daniel  Cox; Philip Townend; Felix  Aigner; Irmgard  Kronberger; Elgun  Samadov; Amer Alderazi; Kamral  Hossain; Greg  Padmore; Gabrielle  van Ramshorst; Ismaïl  Lawani; Anis  Cerovac; Samir  Delibegovic; Glauco  Baiocchi; Gustavo Mendonça  Ataíde Gomes; Igor  Lima Buarque; Muhammad  Gohar; Mihail  Slavchev; Chukwuemeka  Nwegbu; Arnav  Agarwal; Joshua  Ng-Kamstra; Maricarmen  Olivos; Wenhui  Lou; Dong-Lin  Ren; Jose Andres  Calvache; Carlos  J- Perez Rivera; Ana  Danic Hadzibegovic; Tomislav  Kopjar; Jakov  Mihanovic; Pablo Mijahil  Avilés Jiménez; Nikolaos  Gouvas; Jaroslav  Klat; René  Novysedlák; Nicolas  Amisi; Peter Christensen; Alaa El-Hussuna; Sylvia  Batista; Eddy  Lincango-Naranjo; Danilo Alfonso  Arévalo Sandoval; Hailu  Dhufera; Mengistu Gebreyohanes  Mengesha; Joonas H. Kauppila; Zaza  Demetrashvili; Markus  Albertsmeier; Hans  Lederhuber; Markus W.  Löffler; Daniel Kwesi  Acquah; Bernard  Ofori; Symeon  Metallidis; Georgios  Tsoulfas; Maria-Lorena  Aguilera-Arevalo; Gustavo  Recinos; Tamás  Mersich; Dániel  Wettstein; Gabriele  Kembuan; Peiman  Brouki Milan; Mohammad Hossein Khosravi; Masoud  Mozafari; Ahmed  Hilmi; Oded  Zmora; Francesco  Pata; Gianluca  Pellino; Yuki  Fujimoto; Naoto  Kuroda; Sohei  Satoi; Mohamad K.  Abou Chaar; Faris  Ayasra; Ildar  Fakhradiyev; Intisar Hisham Said Hamdun; Jang  Jin-Young; Mohammad  Jamal; Lina  Karout; Aiste  Gulla; Fanjandrainy  Rasoaherinomenjanahary; Luc Hervé  Samison; April Camilla  Roslani; Iran Irani  Durán Sánchez; Diana Samantha  Gonzalez; Laura  Martinez; María José  Martínez; Alejandra  Nayen; Antonio  Ramos-De la Medina; Jade  Nunez; Pueya Rashid  Nashidengo; Rakesh  Shah; Ashish  Lal Shrestha; Pascal  Jonker; Schelto  Kruijff; Milou  Noltes; Pieter  Steinkamp; Lukman  Abdur-Rahman; Adesoji  Ademuyiwa; Adewale  Adisa; Babatunde  Osinaike; Justina  Seyi-Olajide; Omolara  Williams; Emmanuel  Williams; Sofija  Pejkova; Zainab  Al Balushi; Ahmad  Uzair Qureshi; Raza  Sayyed; Mustafa  Abo Mohsen; Sadi A.  Abukhalaf; Moises  Cukier; Hugo  Gomez-Fernandez; Sebastian  Shu Yip; Ximena Paola  Vasquez Ojeda; Marie Dione  Sacdalan; Piotr  Major; Miguel F.  Cunha; Ahmad  Zarour; Eduard-Alexandru  Bonci; Ionut Negoi; Sergey  Efetov; Viktor  Kochetkov; Andrey  Litvin; Jc Allen  Ingabire; Georges  Bucyibaruta; Ntirenganya  Faustin; Sosthene  Habumuremyi; Alphonsine  Imanishimwe; Haragirimana  Jean de Dieu; Emmanuel  Munyaneza; Isaie  Ncogoza; Abdourahmane  Ndong; Dejan  Radenkovic; Min Hoe  Chew; Frederick  Koh; James  Ngu; Arpád  Panyko; Uros  Bele; Jurij Aleš  Košir; Hassan  Daoud; Umesh  Jayarajah; Dakshitha  Wickramasinghe; Mohammed Elmujtba Adam  Essa Adam; Martin  Rutegård; Malin  Sund; Michel  Adamina; Melika  Akhbari; Ruth  Benson; Shivam  Bhanderi; Bruce  Biccard; Edward  Caruana; Sohini  Chakrabortee; Reema  Chapatwala; Ainhoa  Costas-Chavarri; Andreas K  Demetriades; Anant Desai; Salomone  Di Saverio; Thomas M. Drake; John  Edwards; Jonathan P. Evans; Marco Fiore; Samuel J. Ford; Christina  Fotopoulou; Alexander  Fowler; Kaori Futaba; Ian Ganly; Harelimana Grace  James; Ewen Griffiths; Alessandro  Gronchi; Peter  Hutchinson; Gabriella Yael  Hyman; Joseph  Incorvia; Ritu  Jain; Michael  Jenkinson; Tabassum  Khan; Stephen Richard  Knight; Angelos G. Kolias; Søren  Kudsk-Iversen; Tsun Yu  Kwan; Elaine Leung; Julio  Mayol; Siobhan C. McKay; John G.  Meara; Emily  Mills; S. Moug; A Patel; Roberto  Perinotti; Henry Rice; Keith J. Roberts; Andrew Schache; Richard Shaw; Matthew Stephens; Grant D. Stewart; Ella Teasdale; Peter Vaughan-Shaw; Raghavan Vidya; Naomi Wright; Funmilola  Wuraola; David Watson; Tim Bright; Paul Hollington

doi:10.1111/anae.15563

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

COVIDSurg Collaborative, GlobalSurg Collaborative, Alexis P Arnaud, José Azevedo, Ana Maria Minaya Bravo, Daoud Chaudhry, Ehab AlAmeer , Kariem El-Boghdadly , Muhammed Elhadi, Sameh Emile, Gaetano Gallo, James C. Glasbey, Dhruva Ghosh , Arda Isik, Conor S Jones, Sezai Leventoğlu, Elizabeth Li, Janet Martin, Helen M. Mohan, Dmitri NepogodievPranay Pawar, Neil J. Smart, Peter Pockney, Joana F.F. Simoes, Stephen Tabiri, Mary L. Venn, Deborah Wright, Aneel Bhangu, Waheed-Ul-Rahman Ahmed, Leah Argus, Alasdair Ball, Edward P Bywater, Ruth Blanco-Colino, Amanpreet Brar, Brett E Dawson, Irani Duran, Rohan R. Gujjuri, Ewen M Harrison , Sivesh K Kamarajah, James M Keatley, Samuel Lawday, Harvinder Mann, Ella J Marson, Kenneth A Mclean, Lisa Norman , Riinu Ots, Oumaima Outani , Maria Picciochi, Irène Santos, Catherine Shaw , Elliott H Taylor, Isobel M Trout, Chris Varghese, William Xu, Irida Dajti, Arben Gjata, Salah Eddine Oussama Kacimi Oussama Kacimi, Luis Boccalatte, Maria Marta Modolo , Daniel Cox, Philip Townend, Felix Aigner, Irmgard Kronberger , Elgun Samadov, Amer Alderazi, Kamral Hossain, Greg Padmore, Gabrielle van Ramshorst, Ismaïl Lawani, Anis Cerovac, Samir Delibegovic, Glauco Baiocchi, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Muhammad Gohar, Mihail Slavchev, Chukwuemeka Nwegbu, Arnav Agarwal, Joshua Ng-Kamstra, Maricarmen Olivos, Wenhui Lou, Dong-Lin Ren, Jose Andres Calvache, Carlos J- Perez Rivera, Ana Danic Hadzibegovic, Tomislav Kopjar, Jakov Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos Gouvas, Jaroslav Klat, René Novysedlák, Nicolas Amisi, Peter Christensen, Alaa El-Hussuna, Sylvia Batista, Eddy Lincango-Naranjo, Danilo Alfonso Arévalo Sandoval, Hailu Dhufera, Mengistu Gebreyohanes Mengesha , Joonas H. Kauppila, Zaza Demetrashvili, Markus Albertsmeier, Hans Lederhuber, Markus W. Löffler, Daniel Kwesi Acquah, Bernard Ofori, Symeon Metallidis, Georgios Tsoulfas, Maria-Lorena Aguilera-Arevalo, Gustavo Recinos, Tamás Mersich, Dániel Wettstein, Gabriele Kembuan, Peiman Brouki Milan, Mohammad Hossein Khosravi, Masoud Mozafari, Ahmed Hilmi, Oded Zmora, Francesco Pata, Gianluca Pellino, Yuki Fujimoto, Naoto Kuroda, Sohei Satoi , Mohamad K. Abou Chaar, Faris Ayasra, Ildar Fakhradiyev, Intisar Hisham Said Hamdun, Jang Jin-Young, Mohammad Jamal, Lina Karout, Aiste Gulla, Fanjandrainy Rasoaherinomenjanahary, Luc Hervé Samison, April Camilla Roslani , Iran Irani Durán Sánchez, Diana Samantha Gonzalez, Laura Martinez, María José Martínez, Alejandra Nayen, Antonio Ramos-De la Medina, Jade Nunez, Pueya Rashid Nashidengo, Rakesh Shah, Ashish Lal Shrestha, Pascal Jonker, Schelto Kruijff, Milou Noltes, Pieter Steinkamp, Lukman Abdur-Rahman, Adesoji Ademuyiwa, Adewale Adisa, Babatunde Osinaike, Justina Seyi-Olajide, Omolara Williams, Emmanuel Williams, Sofija Pejkova, Zainab Al Balushi, Ahmad Uzair Qureshi , Raza Sayyed, Mustafa Abo Mohsen, Sadi A. Abukhalaf, Moises Cukier, Hugo Gomez-Fernandez, Sebastian Shu Yip, Ximena Paola Vasquez Ojeda, Marie Dione Sacdalan, Piotr Major, Miguel F. Cunha, Ahmad Zarour, Eduard-Alexandru Bonci, Ionut Negoi, Sergey Efetov, Viktor Kochetkov, Andrey Litvin, Jc Allen Ingabire, Georges Bucyibaruta, Ntirenganya Faustin, Sosthene Habumuremyi, Alphonsine Imanishimwe, Haragirimana Jean de Dieu, Emmanuel Munyaneza, Isaie Ncogoza, Abdourahmane Ndong, Dejan Radenkovic, Min Hoe Chew, Frederick Koh, James Ngu, Arpád Panyko, Uros Bele, Jurij Aleš Košir, Hassan Daoud, Umesh Jayarajah, Dakshitha Wickramasinghe, Mohammed Elmujtba Adam Essa Adam, Martin Rutegård, Malin Sund, Michel Adamina, Melika Akhbari, Ruth Benson, Shivam Bhanderi, Bruce Biccard, Edward Caruana, Sohini Chakrabortee, Reema Chapatwala, Ainhoa Costas-Chavarri, Andreas K Demetriades, Anant Desai, Salomone Di Saverio, Thomas M. Drake, John Edwards, Jonathan P. Evans, Marco Fiore, Samuel J. Ford, Christina Fotopoulou, Alexander Fowler, Kaori Futaba, Ian Ganly, Harelimana Grace James, Ewen Griffiths, Alessandro Gronchi, Peter Hutchinson, Gabriella Yael Hyman, Joseph Incorvia, Ritu Jain, Michael Jenkinson, Tabassum Khan, Stephen Richard Knight, Angelos G. Kolias, Søren Kudsk-Iversen, Tsun Yu Kwan, Elaine Leung, Julio Mayol, Siobhan C. McKay, John G. Meara, Emily Mills, S. Moug, A Patel, Roberto Perinotti, Henry Rice, Keith J. Roberts, Andrew Schache, Richard Shaw, Matthew Stephens, Grant D. Stewart, Ella Teasdale, Peter Vaughan-Shaw, Raghavan Vidya, Naomi Wright, Funmilola Wuraola , David Watson, Tim Bright, Paul Hollington

College of Medicine and Public Health

Research output: Contribution to journal › Article › peer-review

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Abstract

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

Original language	English
Number of pages	12
Journal	Anaesthesia
Early online date	24 Aug 2021
DOIs	https://doi.org/10.1111/anae.15563
Publication status	E-pub ahead of print - 24 Aug 2021

Keywords

COVID-19
deep vein thrombosis
pulmonary embolism
SARS-CoV-2
venous thromboembolism

Access to Document

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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85113318546&doi=10.1111%2fanae.15563&partnerID=40&md5=2b586546927be776c9c2cfe614df32ae

Cite this

COVIDSurg Collaborative, GlobalSurg Collaborative, Arnaud, A. P., Azevedo, J., Minaya Bravo, A. M., Chaudhry, D., AlAmeer , E., El-Boghdadly , K., Elhadi, M., Emile, S., Gallo, G., Glasbey, J. C., Ghosh , D., Isik, A., Jones, C. S., Leventoğlu, S., Li, E., Martin, J., Mohan, H. M., ... Hollington, P. (2021). SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study. Anaesthesia. Advance online publication. https://doi.org/10.1111/anae.15563

@article{8abe3697ad3a4461b06d20441be2e936,

title = "SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study",

abstract = "SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.",

keywords = "COVID-19, deep vein thrombosis, pulmonary embolism, SARS-CoV-2, venous thromboembolism",

author = "{COVIDSurg Collaborative} and {GlobalSurg Collaborative} and Arnaud, {Alexis P} and Jos{\'e} Azevedo and {Minaya Bravo}, {Ana Maria} and Daoud Chaudhry and Ehab AlAmeer and Kariem El-Boghdadly and Muhammed Elhadi and Sameh Emile and Gaetano Gallo and Glasbey, {James C.} and Dhruva Ghosh and Arda Isik and Jones, {Conor S} and Sezai Leventoğlu and Elizabeth Li and Janet Martin and Mohan, {Helen M.} and Dmitri Nepogodiev and Pranay Pawar and Smart, {Neil J.} and Peter Pockney and Simoes, {Joana F.F.} and Stephen Tabiri and Venn, {Mary L.} and Deborah Wright and Aneel Bhangu and Waheed-Ul-Rahman Ahmed and Leah Argus and Alasdair Ball and Bywater, {Edward P} and Ruth Blanco-Colino and Amanpreet Brar and Dawson, {Brett E} and Irani Duran and Gujjuri, {Rohan R.} and Harrison, {Ewen M} and Kamarajah, {Sivesh K} and Keatley, {James M} and Samuel Lawday and Harvinder Mann and Marson, {Ella J} and Mclean, {Kenneth A} and Lisa Norman and Riinu Ots and Oumaima Outani and Maria Picciochi and Ir{\`e}ne Santos and Catherine Shaw and Taylor, {Elliott H} and Trout, {Isobel M} and Chris Varghese and William Xu and Irida Dajti and Arben Gjata and {Oussama Kacimi}, {Salah Eddine Oussama Kacimi} and Luis Boccalatte and Modolo, {Maria Marta} and Daniel Cox and Philip Townend and Felix Aigner and Irmgard Kronberger and Elgun Samadov and Amer Alderazi and Kamral Hossain and Greg Padmore and {van Ramshorst}, Gabrielle and Isma{\"i}l Lawani and Anis Cerovac and Samir Delibegovic and Glauco Baiocchi and {Ata{\'i}de Gomes}, {Gustavo Mendon{\c c}a} and {Lima Buarque}, Igor and Muhammad Gohar and Mihail Slavchev and Chukwuemeka Nwegbu and Arnav Agarwal and Joshua Ng-Kamstra and Maricarmen Olivos and Wenhui Lou and Dong-Lin Ren and Calvache, {Jose Andres} and {J- Perez Rivera}, Carlos and {Danic Hadzibegovic}, Ana and Tomislav Kopjar and Jakov Mihanovic and {Avil{\'e}s Jim{\'e}nez}, {Pablo Mijahil} and Nikolaos Gouvas and Jaroslav Klat and Ren{\'e} Novysedl{\'a}k and Nicolas Amisi and Peter Christensen and Alaa El-Hussuna and Sylvia Batista and Eddy Lincango-Naranjo and {Ar{\'e}valo Sandoval}, {Danilo Alfonso} and Hailu Dhufera and Mengesha, {Mengistu Gebreyohanes} and Kauppila, {Joonas H.} and Zaza Demetrashvili and Markus Albertsmeier and Hans Lederhuber and L{\"o}ffler, {Markus W.} and Acquah, {Daniel Kwesi} and Bernard Ofori and Symeon Metallidis and Georgios Tsoulfas and Maria-Lorena Aguilera-Arevalo and Gustavo Recinos and Tam{\'a}s Mersich and D{\'a}niel Wettstein and Gabriele Kembuan and {Brouki Milan}, Peiman and Khosravi, {Mohammad Hossein} and Masoud Mozafari and Ahmed Hilmi and Oded Zmora and Francesco Pata and Gianluca Pellino and Yuki Fujimoto and Naoto Kuroda and Sohei Satoi and {Abou Chaar}, {Mohamad K.} and Faris Ayasra and Ildar Fakhradiyev and {Said Hamdun}, {Intisar Hisham} and Jang Jin-Young and Mohammad Jamal and Lina Karout and Aiste Gulla and Fanjandrainy Rasoaherinomenjanahary and Samison, {Luc Herv{\'e}} and Roslani, {April Camilla} and {Dur{\'a}n S{\'a}nchez}, {Iran Irani} and Gonzalez, {Diana Samantha} and Laura Martinez and Mart{\'i}nez, {Mar{\'i}a Jos{\'e}} and Alejandra Nayen and {Ramos-De la Medina}, Antonio and Jade Nunez and Nashidengo, {Pueya Rashid} and Rakesh Shah and {Lal Shrestha}, Ashish and Pascal Jonker and Schelto Kruijff and Milou Noltes and Pieter Steinkamp and Lukman Abdur-Rahman and Adesoji Ademuyiwa and Adewale Adisa and Babatunde Osinaike and Justina Seyi-Olajide and Omolara Williams and Emmanuel Williams and Sofija Pejkova and {Al Balushi}, Zainab and {Uzair Qureshi}, Ahmad and Raza Sayyed and {Abo Mohsen}, Mustafa and Abukhalaf, {Sadi A.} and Moises Cukier and Hugo Gomez-Fernandez and {Shu Yip}, Sebastian and {Vasquez Ojeda}, {Ximena Paola} and Sacdalan, {Marie Dione} and Piotr Major and Cunha, {Miguel F.} and Ahmad Zarour and Eduard-Alexandru Bonci and Ionut Negoi and Sergey Efetov and Viktor Kochetkov and Andrey Litvin and Ingabire, {Jc Allen} and Georges Bucyibaruta and Ntirenganya Faustin and Sosthene Habumuremyi and Alphonsine Imanishimwe and {Jean de Dieu}, Haragirimana and Emmanuel Munyaneza and Isaie Ncogoza and Abdourahmane Ndong and Dejan Radenkovic and Chew, {Min Hoe} and Frederick Koh and James Ngu and Arp{\'a}d Panyko and Uros Bele and Ko{\v s}ir, {Jurij Ale{\v s}} and Hassan Daoud and Umesh Jayarajah and Dakshitha Wickramasinghe and {Essa Adam}, {Mohammed Elmujtba Adam} and Martin Ruteg{\aa}rd and Malin Sund and Michel Adamina and Melika Akhbari and Ruth Benson and Shivam Bhanderi and Bruce Biccard and Edward Caruana and Sohini Chakrabortee and Reema Chapatwala and Ainhoa Costas-Chavarri and Demetriades, {Andreas K} and Anant Desai and {Di Saverio}, Salomone and Drake, {Thomas M.} and John Edwards and Evans, {Jonathan P.} and Marco Fiore and Ford, {Samuel J.} and Christina Fotopoulou and Alexander Fowler and Kaori Futaba and Ian Ganly and James, {Harelimana Grace} and Ewen Griffiths and Alessandro Gronchi and Peter Hutchinson and Hyman, {Gabriella Yael} and Joseph Incorvia and Ritu Jain and Michael Jenkinson and Tabassum Khan and Knight, {Stephen Richard} and Kolias, {Angelos G.} and S{\o}ren Kudsk-Iversen and Kwan, {Tsun Yu} and Elaine Leung and Julio Mayol and McKay, {Siobhan C.} and Meara, {John G.} and Emily Mills and S. Moug and A Patel and Roberto Perinotti and Henry Rice and Roberts, {Keith J.} and Andrew Schache and Richard Shaw and Matthew Stephens and Stewart, {Grant D.} and Ella Teasdale and Peter Vaughan-Shaw and Raghavan Vidya and Naomi Wright and Funmilola Wuraola and David Watson and Tim Bright and Paul Hollington",

year = "2021",

month = aug,

day = "24",

doi = "10.1111/anae.15563",

language = "English",

journal = "Anaesthesia",

issn = "0003-2409",

publisher = "BLACKWELL PUBLISHERS INC",

}

COVIDSurg Collaborative, GlobalSurg Collaborative, Arnaud, AP, Azevedo, J, Minaya Bravo, AM, Chaudhry, D, AlAmeer , E, El-Boghdadly , K, Elhadi, M, Emile, S, Gallo, G, Glasbey, JC, Ghosh , D, Isik, A, Jones, CS, Leventoğlu, S, Li, E, Martin, J, Mohan, HM, Nepogodiev, D, Pawar, P, Smart, NJ, Pockney, P, Simoes, JFF, Tabiri, S, Venn, ML, Wright, D, Bhangu, A, Ahmed, W-U-R, Argus, L, Ball, A, Bywater, EP, Blanco-Colino, R, Brar, A, Dawson, BE, Duran, I, Gujjuri, RR, Harrison , EM, Kamarajah, SK, Keatley, JM, Lawday, S, Mann, H, Marson, EJ, Mclean, KA, Norman , L, Ots, R, Outani , O, Picciochi, M, Santos, I, Shaw , C, Taylor, EH, Trout, IM, Varghese, C, Xu, W, Dajti, I, Gjata, A, Oussama Kacimi, SEOK, Boccalatte, L, Modolo , MM, Cox, D, Townend, P, Aigner, F, Kronberger , I, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Baiocchi, G, Ataíde Gomes, GM, Lima Buarque, I, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Ng-Kamstra, J, Olivos, M, Lou, W, Ren, D-L, Calvache, JA, J- Perez Rivera, C, Danic Hadzibegovic, A, Kopjar, T, Mihanovic, J, Avilés Jiménez, PM, Gouvas, N, Klat, J, Novysedlák, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Arévalo Sandoval, DA, Dhufera, H, Mengesha , MG, Kauppila, JH, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Löffler, MW, Acquah, DK, Ofori, B, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, M-L, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Brouki Milan, P, Khosravi, MH, Mozafari, M, Hilmi, A, Zmora, O, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Satoi , S, Abou Chaar, MK, Ayasra, F, Fakhradiyev, I, Said Hamdun, IH, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, LH, Roslani , AC, Durán Sánchez, II, Gonzalez, DS, Martinez, L, Martínez, MJ, Nayen, A, Ramos-De la Medina, A, Nunez, J, Nashidengo, PR, Shah, R, Lal Shrestha, A, Jonker, P, Kruijff, S, Noltes, M, Steinkamp, P, Abdur-Rahman, L, Ademuyiwa, A, Adisa, A, Osinaike, B, Seyi-Olajide, J, Williams, O, Williams, E, Pejkova, S, Al Balushi, Z, Uzair Qureshi , A, Sayyed, R, Abo Mohsen, M, Abukhalaf, SA, Cukier, M, Gomez-Fernandez, H, Shu Yip, S, Vasquez Ojeda, XP, Sacdalan, MD, Major, P, Cunha, MF, Zarour, A, Bonci, E-A, Negoi, I, Efetov, S, Kochetkov, V, Litvin, A, Ingabire, JA, Bucyibaruta, G, Faustin, N, Habumuremyi, S, Imanishimwe, A, Jean de Dieu, H, Munyaneza, E, Ncogoza, I, Ndong, A, Radenkovic, D, Chew, MH, Koh, F, Ngu, J, Panyko, A, Bele, U, Košir, JA, Daoud, H, Jayarajah, U, Wickramasinghe, D, Essa Adam, MEA, Rutegård, M, Sund, M, Adamina, M, Akhbari, M, Benson, R, Bhanderi, S, Biccard, B, Caruana, E, Chakrabortee, S, Chapatwala, R, Costas-Chavarri, A, Demetriades, AK, Desai, A, Di Saverio, S, Drake, TM, Edwards, J, Evans, JP, Fiore, M, Ford, SJ, Fotopoulou, C, Fowler, A, Futaba, K, Ganly, I, James, HG, Griffiths, E, Gronchi, A, Hutchinson, P, Hyman, GY, Incorvia, J, Jain, R, Jenkinson, M, Khan, T, Knight, SR, Kolias, AG, Kudsk-Iversen, S, Kwan, TY, Leung, E, Mayol, J, McKay, SC, Meara, JG, Mills, E, Moug, S, Patel, A, Perinotti, R, Rice, H, Roberts, KJ, Schache, A, Shaw, R, Stephens, M, Stewart, GD, Teasdale, E, Vaughan-Shaw, P, Vidya, R, Wright, N, Wuraola , F, Watson, D , Bright, T & Hollington, P 2021, 'SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study', Anaesthesia. https://doi.org/10.1111/anae.15563

TY - JOUR

T1 - SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

AU - COVIDSurg Collaborative

AU - GlobalSurg Collaborative

AU - Arnaud, Alexis P

AU - Azevedo, José

AU - Minaya Bravo, Ana Maria

AU - Chaudhry, Daoud

AU - AlAmeer , Ehab

AU - El-Boghdadly , Kariem

AU - Elhadi, Muhammed

AU - Emile, Sameh

AU - Gallo, Gaetano

AU - Glasbey, James C.

AU - Ghosh , Dhruva

AU - Isik, Arda

AU - Jones, Conor S

AU - Leventoğlu, Sezai

AU - Li, Elizabeth

AU - Martin, Janet

AU - Mohan, Helen M.

AU - Nepogodiev, Dmitri

AU - Pawar, Pranay

AU - Smart, Neil J.

AU - Pockney, Peter

AU - Simoes, Joana F.F.

AU - Tabiri, Stephen

AU - Venn, Mary L.

AU - Wright, Deborah

AU - Bhangu, Aneel

AU - Ahmed, Waheed-Ul-Rahman

AU - Argus, Leah

AU - Ball, Alasdair

AU - Bywater, Edward P

AU - Blanco-Colino, Ruth

AU - Brar, Amanpreet

AU - Dawson, Brett E

AU - Duran, Irani

AU - Gujjuri, Rohan R.

AU - Harrison , Ewen M

AU - Kamarajah, Sivesh K

AU - Keatley, James M

AU - Lawday, Samuel

AU - Mann, Harvinder

AU - Marson, Ella J

AU - Mclean, Kenneth A

AU - Norman , Lisa

AU - Ots, Riinu

AU - Outani , Oumaima

AU - Picciochi, Maria

AU - Santos, Irène

AU - Shaw , Catherine

AU - Taylor, Elliott H

AU - Trout, Isobel M

AU - Varghese, Chris

AU - Xu, William

AU - Dajti, Irida

AU - Gjata, Arben

AU - Oussama Kacimi, Salah Eddine Oussama Kacimi

AU - Boccalatte, Luis

AU - Modolo , Maria Marta

AU - Cox, Daniel

AU - Townend, Philip

AU - Aigner, Felix

AU - Kronberger , Irmgard

AU - Samadov, Elgun

AU - Alderazi, Amer

AU - Hossain, Kamral

AU - Padmore, Greg

AU - van Ramshorst, Gabrielle

AU - Lawani, Ismaïl

AU - Cerovac, Anis

AU - Delibegovic, Samir

AU - Baiocchi, Glauco

AU - Ataíde Gomes, Gustavo Mendonça

AU - Lima Buarque, Igor

AU - Gohar, Muhammad

AU - Slavchev, Mihail

AU - Nwegbu, Chukwuemeka

AU - Agarwal, Arnav

AU - Ng-Kamstra, Joshua

AU - Olivos, Maricarmen

AU - Lou, Wenhui

AU - Ren, Dong-Lin

AU - Calvache, Jose Andres

AU - J- Perez Rivera, Carlos

AU - Danic Hadzibegovic, Ana

AU - Kopjar, Tomislav

AU - Mihanovic, Jakov

AU - Avilés Jiménez, Pablo Mijahil

AU - Gouvas, Nikolaos

AU - Klat, Jaroslav

AU - Novysedlák, René

AU - Amisi, Nicolas

AU - Christensen, Peter

AU - El-Hussuna, Alaa

AU - Batista, Sylvia

AU - Lincango-Naranjo, Eddy

AU - Arévalo Sandoval, Danilo Alfonso

AU - Dhufera, Hailu

AU - Mengesha , Mengistu Gebreyohanes

AU - Kauppila, Joonas H.

AU - Demetrashvili, Zaza

AU - Albertsmeier, Markus

AU - Lederhuber, Hans

AU - Löffler, Markus W.

AU - Acquah, Daniel Kwesi

AU - Ofori, Bernard

AU - Metallidis, Symeon

AU - Tsoulfas, Georgios

AU - Aguilera-Arevalo, Maria-Lorena

AU - Recinos, Gustavo

AU - Mersich, Tamás

AU - Wettstein, Dániel

AU - Kembuan, Gabriele

AU - Brouki Milan, Peiman

AU - Khosravi, Mohammad Hossein

AU - Mozafari, Masoud

AU - Hilmi, Ahmed

AU - Zmora, Oded

AU - Pata, Francesco

AU - Pellino, Gianluca

AU - Fujimoto, Yuki

AU - Kuroda, Naoto

AU - Satoi , Sohei

AU - Abou Chaar, Mohamad K.

AU - Ayasra, Faris

AU - Fakhradiyev, Ildar

AU - Said Hamdun, Intisar Hisham

AU - Jin-Young, Jang

AU - Jamal, Mohammad

AU - Karout, Lina

AU - Gulla, Aiste

AU - Rasoaherinomenjanahary, Fanjandrainy

AU - Samison, Luc Hervé

AU - Roslani , April Camilla

AU - Durán Sánchez, Iran Irani

AU - Gonzalez, Diana Samantha

AU - Martinez, Laura

AU - Martínez, María José

AU - Nayen, Alejandra

AU - Ramos-De la Medina, Antonio

AU - Nunez, Jade

AU - Nashidengo, Pueya Rashid

AU - Shah, Rakesh

AU - Lal Shrestha, Ashish

AU - Jonker, Pascal

AU - Kruijff, Schelto

AU - Noltes, Milou

AU - Steinkamp, Pieter

AU - Abdur-Rahman, Lukman

AU - Ademuyiwa, Adesoji

AU - Adisa, Adewale

AU - Osinaike, Babatunde

AU - Seyi-Olajide, Justina

AU - Williams, Omolara

AU - Williams, Emmanuel

AU - Pejkova, Sofija

AU - Al Balushi, Zainab

AU - Uzair Qureshi , Ahmad

AU - Sayyed, Raza

AU - Abo Mohsen, Mustafa

AU - Abukhalaf, Sadi A.

AU - Cukier, Moises

AU - Gomez-Fernandez, Hugo

AU - Shu Yip, Sebastian

AU - Vasquez Ojeda, Ximena Paola

AU - Sacdalan, Marie Dione

AU - Major, Piotr

AU - Cunha, Miguel F.

AU - Zarour, Ahmad

AU - Bonci, Eduard-Alexandru

AU - Negoi, Ionut

AU - Efetov, Sergey

AU - Kochetkov, Viktor

AU - Litvin, Andrey

AU - Ingabire, Jc Allen

AU - Bucyibaruta, Georges

AU - Faustin, Ntirenganya

AU - Habumuremyi, Sosthene

AU - Imanishimwe, Alphonsine

AU - Jean de Dieu, Haragirimana

AU - Munyaneza, Emmanuel

AU - Ncogoza, Isaie

AU - Ndong, Abdourahmane

AU - Radenkovic, Dejan

AU - Chew, Min Hoe

AU - Koh, Frederick

AU - Ngu, James

AU - Panyko, Arpád

AU - Bele, Uros

AU - Košir, Jurij Aleš

AU - Daoud, Hassan

AU - Jayarajah, Umesh

AU - Wickramasinghe, Dakshitha

AU - Essa Adam, Mohammed Elmujtba Adam

AU - Rutegård, Martin

AU - Sund, Malin

AU - Adamina, Michel

AU - Akhbari, Melika

AU - Benson, Ruth

AU - Bhanderi, Shivam

AU - Biccard, Bruce

AU - Caruana, Edward

AU - Chakrabortee, Sohini

AU - Chapatwala, Reema

AU - Costas-Chavarri, Ainhoa

AU - Demetriades, Andreas K

AU - Desai, Anant

AU - Di Saverio, Salomone

AU - Drake, Thomas M.

AU - Edwards, John

AU - Evans, Jonathan P.

AU - Fiore, Marco

AU - Ford, Samuel J.

AU - Fotopoulou, Christina

AU - Fowler, Alexander

AU - Futaba, Kaori

AU - Ganly, Ian

AU - James, Harelimana Grace

AU - Griffiths, Ewen

AU - Gronchi, Alessandro

AU - Hutchinson, Peter

AU - Hyman, Gabriella Yael

AU - Incorvia, Joseph

AU - Jain, Ritu

AU - Jenkinson, Michael

AU - Khan, Tabassum

AU - Knight, Stephen Richard

AU - Kolias, Angelos G.

AU - Kudsk-Iversen, Søren

AU - Kwan, Tsun Yu

AU - Leung, Elaine

AU - Mayol, Julio

AU - McKay, Siobhan C.

AU - Meara, John G.

AU - Mills, Emily

AU - Moug, S.

AU - Patel, A

AU - Perinotti, Roberto

AU - Rice, Henry

AU - Roberts, Keith J.

AU - Schache, Andrew

AU - Shaw, Richard

AU - Stephens, Matthew

AU - Stewart, Grant D.

AU - Teasdale, Ella

AU - Vaughan-Shaw, Peter

AU - Vidya, Raghavan

AU - Wright, Naomi

AU - Wuraola , Funmilola

AU - Watson, David

AU - Bright, Tim

AU - Hollington, Paul

PY - 2021/8/24

Y1 - 2021/8/24

N2 - SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

AB - SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

KW - COVID-19

KW - deep vein thrombosis

KW - pulmonary embolism

KW - SARS-CoV-2

KW - venous thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=85113318546&partnerID=8YFLogxK

U2 - 10.1111/anae.15563

DO - 10.1111/anae.15563

M3 - Article

SN - 0003-2409

JO - Anaesthesia

JF - Anaesthesia

ER -

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

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