In a large nationwide registry of emergency department (ED) patients tested with a nucleic acid test for suspected SARS-CoV-2, researchers sought to investigate the relationship between SARS-CoV-2 test positivity and subsequent acute vascular thrombosis, including venous thromboembolism (VTE) or arterial thrombosis (AT).

The RECOVER (Roster of Potential COVID-19 in Emergency Care) registry contains 155 emergency departments from around the country. They conducted a retrospective cohort analysis to calculate the odds ratios (ORs) for COVID-19-positive vs. COVID-19-negative status as a predictor of 30-day VTE or AT after controlling for age, gender, active malignancy, intubation, hospital length of stay, and intensive care unit (ICU) treatment.

When 14,056 COVID-19-positive patients were compared to 12,995 COVID-19-negative patients, the overall 30-day prevalence of VTE episodes was 1.4% vs. 1.3% (P=0.44, X2). In addition, testing positive for SARS-CoV-2 status was shown to be adversely linked with both VTE (OR 0.76; 95% CI 0.61-0.94) and AT (OR 0.51; 95% CI 0.32-0.80), whereas intubation, ICU care, and age 50 years or older were favorably associated with both VTE and AT.

In contrast to previous studies, the findings from the large, heterogeneous national sample of ED patients tested for SARS-CoV-2 revealed no link between vascular thrombosis and COVID-19 test positive.