Deep vein thrombosis (DVT) and COVID-19
Written in association with:People with serious COVID-19, and even those that haven't been treated in hospital, are at much higher risk of developing deep vein thrombosis (DVT).
We ask leading consultant vascular surgeon Mr Manj Gohel about just how serious DVT can be for those with COVID-19, and in general, too. Find out more in this informative interview.
What is DVT? What are the main causes?
DVT is short for deep vein thrombosis, also known as blood clots in the veins. It refers to a condition where the main, deep veins in the leg or the abdomen become filled with blood clots. It's a serious condition. It's a common condition. So, around one in a thousand people every year will develop DVT, and so, in the UK, hundreds of thousands or millions of people have had deep vein thrombosis.
The main causes of DVT are not fully understood, but we do know there are certain situations that make you more likely to get DVT. Particularly being in hospital, having an operation, being on a long haul flight or immobility, these are all recognised factors that can cause a DVT.
Often, there are other factors in the individual's medical history. So, if they've got other medical problems, or they're not particularly mobile or potentially if somebody has a blood clotting problem where their blood is more likely to clot, then these are all potential reasons for DVT.
A lot of people who develop DVT have no obvious cause, and so this is one of the great challenges in treating DVT; trying and work about the best treatment for those people where there isn't any obvious cause.
How serious is DVT and what is its relationship with COVID-19?
Deep vein thrombosis, or blood clots in general, are very serious. They are potentially an important and very common cause of people dying in the UK, and around the world. It's a condition that we have to take very seriously.
Now, COVID-19 has obviously been studied extensively in the last two years, and we know that people who have it, particularly serious COVID-19 infection, are at much higher risk of developing blood clots in the lungs, but also in other parts of the body, than the normal population. It's obviously extremely important that this is recognised and certainly in the hospitals where I work, there are clear protocols and pathways for trying to prevent blood clots because of this very strong link with COVID-19.
What are the main symptoms of DVT?
The most common symptoms of DVT are pain and swelling in the leg, particularly the lower leg. Often the leg is red, it's inflamed, it's heavy and so these are the common symptoms. So if somebody has symptoms that are as I've described, then this should result in seeking urgent medical attention. It's important to get a scan and some blood tests to make the diagnosis and to understand whether or not you have a thrombosis.
In some people, the symptoms are less obvious, but those are the most common symptoms;
- Pain
- Swelling
- Redness
- Heaviness of the leg
How can COVID-19 affect or worsen this condition?
Infection with COVID-19 is a significant risk factor for developing deep vein thrombosis or DVT. Efforts to try and prevent infection with vaccination are all extremely important.
The other important contributing factor with COVID, is that any sort of immobility increases your risk of getting thrombosis. So, even the patients who weren't particularly severely infected with COVID-19 or didn't need to go to hospital; if they were more immobile at home or spent more time in bed and weren't as active as normal, then this would also increase the risk of having deep vein thrombosis. And so, DVT rates have almost certainly increased because of the COVID-19 pandemic.
What is the most effective treatment option for DVT?
With the treatment of DVT in its early phase, the most important treatment is blood-thinning medication or anticoagulation. Once a diagnosis of DVT is made, then, almost always people are started on blood-thinning medication, sometime injections but usually tablets. The duration of the blood-thinning medication will depend on the cause of the DVT and where the DVT is. Blood-thinning medication is the most important initial treatment.
There's quite a lot of recent evidence that actually compression stockings or compression treatment on the leg can have a really positive outcome as well. We would normally recommend that people also wear compression, usually with stockings, to try and reduce the swelling and improve symptoms.
Down the line, some people with deep vein thrombosis develop a condition called post-thrombotic syndrome, or PTS. This is an important condition, which occurs when the veins become scarred and damaged after deep vein thrombosis, and this can be a really significant cause of pain, swelling and significant symptoms in the leg which can last for many, many years after deep vein thrombosis.
Again, it's important to emphasise that, although deep vein thrombosis is the cause, the scarring in the veins is what causes these long-term symptoms. The good news is, is that there's been significant advances in the treatment of post-thrombotic syndrome, and there are all sorts of cutting-edge techniques and stents that are now available to try and help people with this really important and miserable complication of deep vein thrombosis.
Concerned about deep vein thrombosis or related vascular issues such as post-thrombotic syndrome? Arrange an appointment via Mr Gohel's Top Doctors profile, for his expert assistance.
