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

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.