Increased Odds of Venous Thromboembolism For Patients With IBD and SARS-CoV-2

Hematology Advisor spoke with experts about the new ASH clinical practice guidelines for VTE.
A new risk stratification score for venous thromboembolism was developed and validated in a cohort of more than 4000 patients with multiple myeloma.
Investigators assessed the risk of developing a venous thromboembolism in patients with IBD who have also contracted SARS-CoV-2.

A significant positive association was reported between SARS-CoV-2 infection and venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD), according to a study published in Gastroenterology.

Researchers used an established Veterans Affairs cohort for this case-crossover study of patients with IBD and VTE. A total of 428 patients diagnosed with IBD before March 1, 2020 who also underwent an incident VTE event between April 1, 2020 and March 30, 2021 were identified.

The mean age of the study cohort was 69 years and the majority were men. Roughly half (49.8%) of patients were being treated with 5-aminosalicylic acid alone and 15.7% were being treated with anti-tumor necrosis factor agents alone.

Over the course of the study period, 58 SARS-CoV-2 infections were identified. Of these, 21 occurred within 30 days prior to a VTE event. SARS-CoV-2 infection was associated with 8.15-fold increased odds of VTE (95% CI, 4.34-15.30; P <.001), after adjusting for recent hospitalization and steroid exposure.

There was no significant association between SARS-CoV-2 infection and VTE events when limiting the analysis to patients taking chronic anticoagulation medications (OR, 0.63; 95% CI, 0.08-5.15; P =.66), though the association was stronger among patients not previously on anticoagulation medications (OR, 14.31; 95% CI, 6.90-29.66; P <.001).

This study was limited by its retrospective nature. Furthermore, investigators noted additional thrombotic episodes may have occurred outside the Veterans Affairs system and thus not been included in analysis.

According to researchers, “Our data suggest that IBD patients who contract SARS-CoV-2 have a substantially increased risk of VTE and may therefore benefit from prophylaxis.”


Mahmud N, Weiss A, Trivedi C, Yang Y-X, Lewis J, Khan N. Risk of venous thromboembolism among inflammatory bowel disease patients who contract SARS-CoV-2. Gastroenterol. Published online June 14, 2021. doi:10.1053/j.gastro.2021.06.012