Surgical patients may be at high risk of venous thromboembolism (VTE). SARS‐CoV‐2 infection has been shown to increase this risk. In this huge international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020, the authors included 123,791 patients from all surgical specialities in 1630 hospitals and 115 countries.

The primary outcome measure was VTE (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as perioperative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none.  Postoperative VTE rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with perioperative SARSCoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARSCoV-2.

Of note, information on prophylaxis regimens or preoperative anticoagulation for baseline comorbidities was not available. However, by multiplying the VTE risk by a factor of four, perioperative SARS‐CoV‐2 infection appears as a major VTE risk factor in surgery. Maybe the most important one.

– Charles Marc Samama