Impact of the COVID-19 pandemic and a national lockdown on hospitalizations for venous thromboembolism and pulmonary embolism in France

BACKGROUND: The COVID-19 pandemic and the national lockdown implemented in France have disturbed populations’ health behavior and overwhelmed hospitals. Furthermore, infection to SARS-CoV-2 has been found to be directly associated with an increased risk of venous thrombosis (VT) and pulmonary embolism (PE). PURPOSE: This study aimed to analyze the impact of the COVID-19 pandemic on the epidemiology of hospitalizations for VT and PE in France – with a special focus on the first lockdown period – in terms of the rates of patients hospitalized in 2020 versus 2017–19, their characteristics, and related in-patient and 90-day case-fatality rates. A secondary objective aimed at describe the prevalence of COVID-19 among patients hospitalized with VT and PE, respectively. METHODS: All patients hospitalized with a diagnosis of VT and PE respectively in France between January and September (weeks 1–40) of each year from 2017 to 2020 were selected. Weekly incidence rates ratios (IRR) were computed to compare the rates of patients hospitalized between 2020 and 2017–2019. RESULTS: Compared with the 2017–2019 study period, the rates of patients hospitalized with a primary diagnosis (PD) of VT or PE in 2020 were significantly (50 and 40%, respectively) lower during weeks 12–13. By contrast, the rate of patients hospitalized with an associated diagnosis (AD) of PE during the country's first lockdown (weeks 12–19 of 2020) was twice as high as in the same period in 2017–2019, and even three times higher in week 13. The prevalence of COVID-19 in patients hospitalized with a PD of VT and PE, and in those hospitalized with an AD of VT and PE reached, respectively, 4.0, 9.6, 17.2 and 44.6 during the lockdown (weeks 12–19). Inpatients case-fatality rates in patients hospitalized with an AD of PE increased significantly during weeks 12–13. CONCLUSION: This study highlights significant changes in the epidemiology of hospitalized VT and PE induced by the COVID-19 pandemic.