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No Increase Seen in Outpatient VTE for SARS-CoV-2-Positive Patients

TUESDAY, April 6, 2021 -- The incidence of outpatient venous thromboembolism (VTE) is similar among symptomatic patients with a positive versus negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test, according to a research letter published online April 5 in JAMA Internal Medicine.

Nareg H. Roubinian, M.D., from Kaiser Permanente Northern California in Oakland, and colleagues examined the 30-day incidence of outpatient and hospital-associated VTE in a cohort study of 220,588 adult members of the Kaiser Permanente Northern California health plan who were tested for SARS-CoV-2.

The researchers found that 11.8 percent of those tested were positive for SARS-CoV-2 infection. Within 30 days of testing, a VTE was diagnosed in 198 and 1,008 patients with a positive and negative SARS-CoV-2 result, respectively (0.8 versus 0.5 percent, respectively). For most of the patients who had a positive SARS-CoV-2 result and developed VTE, viral testing took place in an outpatient setting (59.1 percent); 76.1 percent of these patients required subsequent hospitalization. Among patients who underwent outpatient viral testing, 30-day VTE incidence was higher among those with a positive versus a negative result (4.7 versus 1.6 cases per 1,000 tested). Patients with a positive versus a negative SARS-CoV-2 result had a significantly higher 30-day incidence of hospital-associated VTE (5.8 versus 3.0 per 1,000 tested), but not outpatient VTE (1.8 versus 2.2 cases per 1,000 tested).

"These findings suggest that VTE incidence outside of the hospital is not significantly increased with SARS-CoV-2 infection and argue against the routine use of outpatient thromboprophylaxis outside of clinical trials," the authors write.

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