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Surgical patients who have recently recovered from Covid-19 are at an increased risk of developing fatal blood clots after an operation, research has found.
A global study by the University of Birmingham, which worked with surgeons and anaesthetists around the world, found patients diagnosed with coronavirus were more likely to develop postoperative venous thromboembolism than those with no history of infection.
Patients who had to go to hospital with Covid-19 had previously shown a high risk of VTE, of between 9 per cent and 26 per cent, despite the use of preventive drugs.
Researchers found it to be as high as 31 per cent in coronavirus patients in critical care settings and confirmed an increased risk in those who needed surgery.
Although VTE is preventable with anticoagulant medication, compression stockings and exercises, it can cause disability or death if left undiagnosed. Twelve hospitals in the UAE were involved in the global study.
“The findings of this new global study, in which the GCC region has played a key role, will help us to understand the impact of Covid-19 and arm us in our collective fight against the pandemic,” said Dr Hayder Saleh Abdulhadi Alsaadi, adjunctive clinical associated professor at Dubai Medical University and surgeon at Rashid Hospital in Dubai.
“As one of the countries spearheading the global efforts against Covid-19, whether through vaccine distribution or mask production, we are proud to be playing a central part in clinical research.
“We hope these new findings will strengthen our collective resolve and contribute to the global mission.”
A global effort
Medics and academics analysed data from 128,013 patients in 1,630 hospitals across 115 countries, with results published in health journal Anaesthesia.
The study involved data from 26 hospitals in Saudi Arabia, four in Bahrain, seven in Kuwait, three in Qatar and two in Oman.
The 12 UAE hospitals involved in the study were: Mediclinic Al Noor Hospital and Sheikh Shakhbout Medical City in Abu Dhabi, Al Jalila Children’s Speciality Hospital, Burjeel Hospital for Advanced Surgery, Dubai Hospital, Latifa Women and Children Hospital, Medcare Orthopaedic and Spine Hospital, Mediclinic City Hospital Dubai, Mediclinic Parkview Hospital, Mediclinic Welcare Hospital, Neuro Spinal Hospital, Rashid Hospital in Dubai, and Al Qassimi Hospital in Sharjah.
Researchers examined data from adult patients, aged 18 and over, having elective or emergency surgery.
Those having surgery go through a procedure which artificially produces a wound. This increases the risk of bleeding, and causes a series of inflammatory responses in the body known to alter haemodynamics - the factors that govern blood flow and coagulation.
Doctors involved in the research found an independent association between VTE and a patient's chance of dying within 30 days. This risk increased by five times in patients who develop a blood clot.
“People undergoing surgery are already at higher risk of VTE than the general public, but we discovered that a current or recent Sars-CoV-2 infection was associated with greater risk of postoperative VTE,” said the report’s co-author Elizabeth Li, clinical research fellow at the University of Birmingham.
“Most surgical patients have risk factors for VTE, including immobility, surgical wounds and systematic inflammation; the addition of Sars-CoV-2 infection may further increase this risk.”