Demelo Rodríguez, PabloAlonso Beato, RubénJara Palomares, LuisGaleano Valle, FranciscoBuraR iviere, AlessandraVisonà, AdrianaIria, FranciscoVidal, GemmaLópez Ruiz, AntonioMonreal, Manuel2025-12-182025-12-182023-09-20Demelo-Rodríguez P, Alonso-Beato R, Jara-Palomares L, Galeano-Valle F, Bura-Riviere A, Visonà A, Francisco I, Vidal G, López-Ruiz A, Monreal M; RIETE Investigators. COVID-19-associated venous thromboembolism: risk of recurrence and major bleeding. Res Pract Thromb Haemost. 2023;7(7):102206. doi: 10.1016/j.rpth.2023.102206. PMID: 37840687; PMCID: PMC10569976.2475-037910.1016/j.rpth.2023.102206https://hdl.handle.net/20.500.14352/129271Background Complications under anticoagulant treatment in patients with COVID-19-associated venous thromboembolism (VTE) have not been consistently reported. Objectives This study aimed to compare the 90-day rates of VTE recurrences and major bleeding in patients with COVID-19-associated VTE versus those with VTE without COVID-19. Methods We used the RIETE registry to compare the 3-month outcomes in patients with COVID-19-associated VTE versus those with VTE without COVID-19. Results The study included 1,747 patients with COVID-19-associated VTE and 8,711 with VTE without COVID-19. Patients with COVID-19-associated VTE were more likely to be hospitalized at baseline and to present with pulmonary embolism. During the first 90 days, 123 patients (1.17%) developed VTE recurrences, and 266 (2.54%) experienced major bleeding. Patients with COVID-19-associated VTE had a similar rate of VTE recurrences (0.9% vs 1.2%) but a higher rate of major bleeding (4.6% vs 2.1%; P < .001) than those without COVID-19. Multivariable analysis adjusted for competing risks showed that patients with COVID-19-associated VTE had an increased risk of major bleeding (subhazard ratio, 1.395; 95% confidence interval, 1.037-1.877). The 30-day mortality after major bleeding was 26.3% in patients with COVID-19-associated VTE and 17.7% in those without COVID-19. Conclusion Patients with COVID-19-associated VTE had a 5-fold higher rate of major bleeding than VTE recurrences during the first 90 days of anticoagulation. In VTE patients without COVID-19, both rates were similar. These findings highlight the importance of carefully monitoring and optimizing anticoagulation in these patients.engAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/journal articlehttps://doi.org/10.1016/j.rpth.2023.102206https://www.sciencedirect.com/science/article/pii/S2475037923004636?via%3Dihub&__cf_chl_tk=ZLG3RavwbomTuuwsp2eBF.51ZAe9oivSoQYyZBrjgRA-1766045205-1.0.1.1-k5ikZF_TrpJHzGMxfulpyOHvJYTxGCfq7fzXEQcJvskopen accessAnticoagulantsCOVID-19HemorrhagePulmonary embolismVenous thromboembolismCiencias Biomédicas32 Ciencias Médicas