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Revisiting Traveler’s Thrombosis and COVID-19 Links

New patterns in traveler’s thrombosis and COVID-19-related thrombosis are revealed.

― 5 min read


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Traveler’s thrombosis, often called “economy class syndrome,” occurs when blood clots form in the veins, particularly during long flights. This topic has been discussed for years, yet there is still debate around its history and how it compares to recent studies on blood clots related to COVID-19. Given the confusion in these areas, we believe there might be missed insights that could clarify the situation.

Traditional methods of reviewing existing studies, like systematic reviews and meta-analyses, have already been applied to these topics without revealing new findings. As a result, using a fresh approach seems necessary. While some software can spot research fraud in published figures, it doesn't highlight overlooked information in previously published data. Usually, studies focus on numerical data in tables, but the visual representations in figures tend to be neglected.

In our analysis, we specifically looked at figures, paying attention to their designs and Patterns. By viewing these figures through a geometrical lens, we aim to identify any hidden knowledge that may not have been previously recognized.

Observing Patterns in Figures

We began by examining a specific figure related to meta-regression analysis from an earlier study. This figure displayed layered hyperbolic patterns which could indicate the presence of underlying subgroups. We proposed a hands-on pattern recognition method to search for these hyperbolic shapes in figures, using the relationship between confidence interval length and patient population size as our guide.

The edges of the hyperbolic shapes we reviewed were formed through a combination of two types of curving lines, which include an S-shaped curve and a U-shaped curve. Our focus was primarily on the U-shaped curve, which relates the length of the confidence intervals to patient population sizes. We acknowledge that while differences in sample sizes can influence confidence intervals, certain factors can minimize this confusion.

Results from Analysis of Traveler’s Thrombosis

Using our method, we analyzed the data from various studies on traveler’s thrombosis. We concentrated on retrieving overlooked insights from this data. During our investigation, we discovered that some studies contained unreliable data due to unique design choices. We excluded data from these studies before applying our pattern recognition analysis to the remaining datasets.

Our examination revealed layered hyperbolic patterns when we focused on two sets of data, each yielding inflection points at different hours of travel. Additionally, we noticed a surprising cyclical pattern regarding when blood clots developed post-travel, with a cycle length of approximately 27 days. This pattern is intriguing because it could hint at factors affecting thrombosis which had not been clearly articulated in prior research.

Investigating COVID-19-Related Thrombosis

Building on our findings from traveler’s thrombosis, we also looked into thrombosis cases linked to COVID-19. Given the debates surrounding COVID-19-related thrombosis, we felt it was essential to apply our geometrical analysis approach to uncover overlooked insights.

While conducting our analysis, we assessed another dataset and recognized that certain patterns emerged that matched our earlier findings with traveler’s thrombosis. We also found subgroups within the COVID-19 data that displayed distinct characteristics, reinforcing the idea of shared Risk Factors with traveler’s thrombosis.

Interestingly, we observed clusters in the data that could be fitted with specific shapes. These patterns shed light on potential connections between biomarkers and COVID-19, suggesting that there may be varying underlying mechanisms at play.

The Role of Hormonal Treatments

Another vital aspect of both traveler’s thrombosis and COVID-19-related thrombosis is the influence of hormonal treatments like oral contraceptives (OC) and hormone replacement therapy (HRT). Our analysis revealed that certain patterns of thrombosis onset correlate with the use of these hormonal treatments.

Specifically, we found that the cyclical patterns might align with typical usage patterns of OC and HRT, indicating that the timing of travel could coincide with the initiation or adjustment of these medications. This relationship suggests the need for caution when prescribing these treatments, particularly for individuals planning to travel.

Looking at Risks in Different Age Groups

Our reviews also pointed out that the risk of developing thrombosis increases at certain ages. We found that younger adults tend to have different risk factors compared to older individuals. For men, stress related to life events may contribute to these risks.

For women, especially during specific age groups like the menopausal phase, the onset of thrombosis could coincide with hormonal changes and travel. The findings from the studies indicated that a significant increase in thrombosis cases among females occurred around the time that many women begin hormonal treatments.

Patterns and Environmental Factors

The environment in flights has long been thought to contribute to thrombosis. However, our findings imply that other factors, such as the influence of hormonal treatments and life events, may play a more critical role than previously thought.

Given the cyclical patterns we identified, it seems more appropriate to view cases of traveler’s thrombosis not merely as a product of flying but as interconnected with broader lifestyle and health changes. This perspective encourages more comprehensive research into the role of both environmental factors and personal health choices in thrombosis risk.

Conclusion

In summary, our analysis of traveler’s thrombosis and COVID-19-related thrombosis has uncovered several overlooked patterns and relationships. The interplay between travel, hormonal treatments, age, and life events can clarify the ongoing debates surrounding these issues.

This study encourages a more nuanced view of thrombosis, where traditional ideas around flight-related risks are re-evaluated. Instead of seeing thrombosis merely through the lens of travel, it may be more beneficial to consider it a lifecycle event, influenced by a combination of travel, health choices, and other external factors.

Going forward, further investigation into these intricate relationships is vital as it could lead to more effective prevention strategies for both traveler’s thrombosis and COVID-19-related thrombosis.

Original Source

Title: Travel-related Twenty-eight Days Cyclical Thrombosis and Subgroups of COVID-19 Cardiac Biomarker Data: Novel Review Strategy and Meta-analysis Method

Abstract: BackgroundsStrange controversies have remained in thrombosis-related fields (travelers and COVID-19-related thrombosis), although travelers thrombosis is well-known even among non-professionals as "economy class syndrome." We hypothesized there might be something overlooked behind those strange situations. MethodsSince ordinary review methods (e.g., systematic review or meta-analysis) had already been conducted, we focused on reviewing a "previously published" "chart." Also, we developed a novel "review method" for the meta-regression analysis result. We applied those to some previously published and well-known data. ResultsWe newly found an approximately 28 days cycle of thrombosis onset over several weeks after travel in a figure. Also, we found an eighteen-day cycle of thrombosis onset in another chart. In COVID-19 cardiovascular biomarker studies, we newly extracted subgroup patterns in a scatterplot (Troponin T and NT-proBNP) that applied simple linear regression analysis. Also, these subgroups had already appeared in the cardiomyopathy study. ConclusionsTravelers thrombosis sometimes occurs over two months after leaving the risky in-flight environment. This phenomenon has been explained that the thrombus is formed in a cabin but dislodged after. However, from the cyclic patterns, explaining that the "high-risk period of thrombosis with Oral Contraceptive (OC) use initiation" coincided with "travel" is more reasonable (e.g., honeymoon and OC initiation). Regarding risk-benefit balance, it is conceivable that "spreading the risk" by starting the dosing away from the travel period is essential to ensure safer use because the in-flight environment may have a non-zero effect, and optimal care by a primary care physician (prescriber) is not available during the travel. In COVID-19, there seems to be a complex scatterplot structure that is unsuitable for usually used simple linear fitting. In a literature review, a pattern on a chart should be given more paying attention.

Authors: Keiichiro Kimoto, M. Yamakuchi, K. Takenouchi, T. Hashiguchi

Last Update: 2023-08-25 00:00:00

Language: English

Source URL: https://www.medrxiv.org/content/10.1101/2022.06.06.22275944

Source PDF: https://www.medrxiv.org/content/10.1101/2022.06.06.22275944.full.pdf

Licence: https://creativecommons.org/licenses/by/4.0/

Changes: This summary was created with assistance from AI and may have inaccuracies. For accurate information, please refer to the original source documents linked here.

Thank you to medrxiv for use of its open access interoperability.

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