{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:54:51Z","timestamp":1760144091155,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: COVID-19 increases the risk of venous thromboembolism (VTE) through a complex interplay of mechanisms collectively referred to as immunothrombosis. Limited data exist on VTE challenges in the acute setting throughout a dynamic long-term follow-up of COVID-19 patients compared to non-COVID-19 patients. The aim of the study was to investigate acute and long-term management and complications in VTE patients with and without COVID-19. Methods: A prospective, observational, single-center cohort study on VTE patients followed from the acute care stage until 24 months post-diagnosis. Results: 157 patients, 30 with COVID-19-associated VTE and 127 unrelated to COVID-19, were enrolled. The mean follow-up was 10.8 (\u00b18.9) months. COVID-19 patients had fewer comorbidities (1.3 \u00b1 1.29 vs. 2.26 \u00b1 1.68, p &lt; 0.001), a higher proportion of pulmonary embolism at baseline (96.7% vs. 76.4%, p = 0.01), and had a lower probability of remaining on anticoagulant therapy after three months (p &lt; 0.003). The most used initial therapy was low-molecular-weight heparin in 130\/157 cases, followed by long-term treatment with direct oral anticoagulants in 123\/157. Two (6.7%) COVID-19 vs. three (2.4%) non-COVID-19 patients (p = 0.243) had major hemorrhagic events, all of them within the first three months. Four (3.1%) non-COVID-19 patients had VTE recurrence after six months. Three (2.4%) non-COVID-19 patients developed chronic thromboembolic pulmonary hypertension. There were no fatalities among patients with COVID-19, compared to a mortality of 12\/127 (9.4%) in the non-COVID-19 subgroup (p = 0.027). Discussion: Our study offers a comprehensive overview of the evolving nature of VTE management, emphasizing the importance of personalized risk-based approaches, including a limited course of anticoagulation for most COVID-19-associated VTE cases and reduced-dose extended therapy for high-risk subsets.<\/jats:p>","DOI":"10.3390\/jcm13061825","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T05:10:53Z","timestamp":1711084253000},"page":"1825","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Venous Thromboembolism Management throughout the COVID-19 Era: Addressing Acute and Long-Term Challenges"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1078-1632","authenticated-orcid":false,"given":"Maddalena Alessandra","family":"Wu","sequence":"first","affiliation":[{"name":"Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20156 Milan, Italy"},{"name":"Department of Biomedical and Clinical Sciences, University of Milan, 20156 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Taino","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20156 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Facchinetti","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Rossi","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20156 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Division of Cardiology, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1151-7040","authenticated-orcid":false,"given":"Silvia","family":"Berra","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20156 Milan, Italy"},{"name":"Department of Biomedical and Clinical Sciences, University of Milan, 20156 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Blanda","sequence":"additional","affiliation":[{"name":"Department of Radiology, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5314-8944","authenticated-orcid":false,"given":"Nicola","family":"Flor","sequence":"additional","affiliation":[{"name":"Department of Radiology, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Cogliati","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20156 Milan, Italy"},{"name":"Department of Biomedical and Clinical Sciences, University of Milan, 20156 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9616-803X","authenticated-orcid":false,"given":"Riccardo","family":"Colombo","sequence":"additional","affiliation":[{"name":"Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20156 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1002\/ajh.26996","article-title":"Venous thromboembolism mortality and trends in older US adults, 2011\u20132019","volume":"98","author":"Giorgio","year":"2023","journal-title":"Am. 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