The risk of developing a blood clot remained elevated almost a year after a COVID-19 infection, according to a new U.K. study that looked at the health records of 48 million unvaccinated adults, covering almost the entire adult English and Welsh populations, from the first year of the pandemic.
In a peer-reviewed paper published by the American Heart Association’s Circulation journal, researchers estimated that in 2020, COVID-19 resulted in more than 10,500 additional heart attacks, strokes, and other blood clot-related events in England and Wales. While excess risks were overall small and fell over time, researchers still found that the chances of developing a venous thromboembolism (VTE) following a COVID-19 diagnosis remained almost twice as high for up to 49 weeks following a positive test, compared to people who were not diagnosed with the viral infection.
VTEs are blood clots in the veins, which the U.S. Centers for Disease Control and Prevention says is a serious and underdiagnosed, yet preventable condition that can cause disability and death. A clot in the lungs is an example of VTE. Arterial thrombosis is a clot that develops in an artery and is also potentially dangerous.
“We are reassured that the risk drops quite quickly – particularly for heart attacks and strokes – but the finding that it remains elevated for some time highlights the longer-term effects of COVID-19 that we are only beginning to understand,” said the study’s co-lead, Jonathan Sterne, a professor of medical statistics and epidemiology at the University of Bristol, in a statement. Sterne is also the director of the NIHR Bristol Biomedical Research Centre and director of Health Data Research UK South West.
Like previous studies on blood clots, the team led by the Universities of Bristol, Cambridge, and Edinburgh, and Swansea University, also found that risks of developing vascular disease climbed “markedly higher” in the first one to two weeks following confirmation of COVID-19, a risk that did decline over time. Unlike (the risk of?) arterial thromboses, which declined quickly following initial infection, however, VTE risks remained more elevated. Researchers did find that the relative incidences of both arterial thrombosis and VTE remained higher for longer especially in patients who were hospitalized.
Overall, the team found that within the first week of testing positive for COVID-19, patients were 21 times more likely to have artery-blocking clots, which can lead to heart attacks and stroke. This risk dropped to 1.3 times more likely sometime after six months. For VTE, elevated risks went from 33 times more likely in the first week, to 1.8 times between 27 and 49 weeks.
While there was little association between COVID-19 and blood clot risks by age, researchers did find that Black and Asian people, and those with a history of blood clots, were at higher risk compared to patients who were white. Those with only mild or moderate cases of COVID-19 were also affected, although their excess risk was generally lower than those with severe infections.
“We have shown that even people who were not hospitalised faced a higher risk of blood clots in the first wave,” said Angela Wood, a professor of biostatistics at the University of Cambridge and a co-lead in the study.
“While the risk to individuals remains small, the effect on the public’s health could be substantial and strategies to prevent vascular events will be important as we continue through the pandemic.”
The research team used anonymized electronic health records across the entire English and Welsh population from January 1 to December 7, 2020 to analyze the data, which included looking at the severity of a patient’s COVID-19 infection, the demographics of the patients and their medical history. The data collected would have been prior to the mass vaccination campaign and before variants like Delta and Omicron became dominant.
“The large number of COVID-19 infections in England and Wales during 2020 and 2021 is likely to have caused a substantial additional burden of arterial thromboses and VTEs,” the paper’s authors wrote, recommending that preventative strategies like a health review with a primary care doctor and managing high-risk patients could help reduce incidences of dangerous blood clots. They noted that the opposite occurred during the pandemic – fewer patients saw doctors, which led to fewer routine health checks for those with chronic medical issues and fewer prescriptions given to patients for drugs that can help lower blood pressure and cholesterol.
Researchers noted some limitations to the study, including the fact that patients who died in nursing homes from a blood clot-related event may not have been recorded as such, due to a lack of diagnostic resources for example. Some people experiencing milder cases of blood clotting may have also avoided going to the doctor or hospital due to concerns over catching COVID-19. The data collected also did not include information on certain milder forms of clots. In addition, the authors noted that testing for COVID-19 was not widely available for mild or asymptomatic cases during the early days of the pandemic.
Looking ahead, researchers are studying data from after 2020 to better understand how vaccinations and other variants impact vascular health.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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