Manj Gohel (Cambridge, UK) is joined by a host of venous experts including Beverley Hunt (London, UK), Stephen Black (London, UK) and Ian Franklin (London, UK) to look at the long-term impact of the COVID-19 crisis on the treatment of chronic venous disease.
Hunt says that “we are seeing hospital-acquired VTE (venous thromboembolism)” occurring in COVID patients with “really pro-inflammatory changes in their blood”. These patients don’t need long-term anticoagulation because “these are profoundly provoked events”, adds Hunt who concludes that “the question we are not sure about” is if patients who have severe inflammation in their lungs and are getting small vessel thrombosis as a result of the disease, “will it mean that down the line they might have pulmonary hypertension?”
Black says that for venous patients in particular “we at least have the opportunity to monitor symptoms and look for deterioration”. It’s “quite clear” that most venous problems can be put on a monitoring phase and “even patients with leg ulcers can be stabilised in bandages during COVID with a view to treating these patients when the crisis passes”, he adds.
Franklin notes that “in terms of what will happen when this is all over – certainly it seems the patients who survive, they’re going to have a lot of ongoing problems and many of them are going to be at risk of deep vein thrombosis and pulmonary embolism” so may need ongoing care from venous specialists moving forward.
Gohel explains that there will “almost certainly be a massive long-term impact on our ability to treat our patients with venous disease after this current crisis” before concluding that “we need to focus on the evidence and on the enormous quality of life benefits we can deliver and I think in due course we will be able to get back to some sort of normality”.
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