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

Anderson, Jana J.; Ho, Frederick K.; Niedzwiedz, Claire L.; Katikireddi, Srinivasa Vittal; Celis‐Morales, Carlos; Iliodromiti, Stamatina; Welsh, Paul; Pellicori, Pierpaolo; Demou, Evangelia; Hastie, Claire E.; Lyall, Donald M.; Gray, Stuart R.; Forbes, John F.; Gill, Jason M. R.; Mackay, Daniel F.; Berry, Colin; Cleland, John G. F.; Sattar, Naveed; Pell, Jill P.

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.