Impact of the COVID-19 Pandemic on Splanchnic Thrombosis Mortality: A United States National Analysis (2018-2023)

Background Coronavirus disease 2019 (COVID-19) has been associated with systemic effects that may influence thrombotic risk. While venous thromboembolism has been widely reported, national mortality trends for splanchnic thrombosis, including portal vein thrombosis, Budd-Chiari syndrome, mesenteric venous thrombosis, and mesenteric ischemia, remain poorly characterized. Methods The CDC WONDER Multiple Cause of Death database was queried for 2018-2023. Annual deaths, population counts, and crude mortality rates per 100,000 persons were extracted and stratified by year and sex. Mortality patterns during the pre-pandemic period (2018-2019) were compared with the pandemic/post-pandemic period (2020-2023) using descriptive trend analysis. Results A total of 32,738 deaths were attributed to splanchnic thrombosis during the study period. Annual deaths increased from 4,819 in 2018 to 5,986 in 2023. The pre-COVID-19 annual average was 4,931 deaths compared with 5,719 deaths during 2020-2023, representing a 16.0% relative increase. Crude mortality rates rose from 1.5 per 100,000 (2018-2019) to 1.7-1.8 per 100,000 (2021-2023). Increases were observed in both sexes. Conclusions Mortality from splanchnic thrombosis increased during the COVID-19 era. These findings demonstrate a temporal rise in mortality; however, the study design is descriptive and does not establish causality. Further research is needed to evaluate potential contributing factors and clinical implications.