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The optimal duration of anticoagulation therapy in patients with COVID-19–associated venous thromboembolism (VTE) is unclear. In this prospective multinational study of 431 patients (mean age, 62) who had proximal deep venous thrombosis or pulmonary embolism within 30 days of SARS-CoV-2 infection, researchers determined the rate of VTE recurrence after discontinuing anticoagulation therapy.
Anticoagulation was discontinued in all patients after at least 3 months of treatment (median, 4.6 months). During a median post-anticoagulation follow-up of 6 months, 11 patients experienced recurrent VTE. The rate of recurrent VTE was 4.8 per 100 patient-years. During follow-up, 11 deaths occurred, but none were due to VTE.
Jara-Palomares L et al. Rate of recurrence after discontinuing anticoagulation therapy in patients with COVID-19–associated venous thromboembolism. JAMA Intern Med 2022 Nov 7; [e-pub]. (https://doi.org/10.1001/jamainternmed.2022.4954)
Comment
In this study, the rate of VTE recurrence after discontinuing anticoagulation in patients with COVID-19–associated VTE was similar to that in patients with VTE caused by transient nonsurgical conditions. Inflammation likely mediated the excess risk for VTE during COVID-19 and diminished over time during recovery. These findings support a limited course of anticoagulation (i.e., 3 months) in patients with COVID-19–associated VTE. Furthermore, doing so aligns with current guidelines (Chest 2021; 160:2247).