COVID-19, long flights, and deep vein thrombosis: What we know so far

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) pandemic has presently stunted the growth of the airline industry. Despite the setbacks, pre-COVID-19 passenger numbers are forecasted to return by as early as 2024. As the industry recovers, the number of long-distance flights will surely continue to increase like it did before the pandemic. The incidence of venous thromboembolism (VTE) following air travel is also likely to increase. Although not common, the unique environment of air travel exposes individuals with particular health conditions to an elevated risk of acquiring VTEs. Numerous factors increasing the risk of developing VTE related to air travel have been identified, including inherited and acquired flight-related aspects. Non-pharmacological approaches to reduce air travel-related VTEs involve simple foot movements, compression socks and stockings, intermittent pneumatic compression devices, a novel modified airline seat, and foot exercisers. Pharmacological methods include heparins and direct oral anticoagulants. More than 30 reliable articles were evaluated to present the current knowledge regarding air travel-related VTEs, their risk factors, and prophylactic methods. Issues in research methodologies found in the literature were identified and discussed. Further research involving international collaboration projects is recommended. The authors' perspectives regarding long flights in previously infected COVID-19 individuals are also included.

Keywords: COVID-19; deep vein thrombosis; economy class syndrome; pulmonary embolism; travel-related illness; venous thromboembolism.

Central Illustration. Graphical summary of the article’s findings on air travel-related venous thromboembolism (VTE); DVT — deep vein thrombosis.