well as other thrombotic events, like ischemic stroke after COVID-19. Let's look at a few more studies that really highlight the clinical data that we see. Dr. Henry: Henry: So this was a great review that looked at some of the early data that we had to support abnormal coagulation with Long COVID and again they started to put together this picture pretty early on that we see increased risk of venous thromboemboli and arterial thromboemboli after discharge and if that post discharge anticoagulation reduced the risk by about 46%. This was an excellent study that's done by Giannis, et al, back in 2020. A few other things that they started to point out in their review on this study by Pasini, which I think we'll talk about a little bit later. They found a persistence of altered D-dimer levels, raises the possibility of thromboembolic disease and overall, they started to see a number of studies that reported different clotting pathologies in Long COVID that suggested that we might want to pay attention to abnormal coagulation as a major factor in Long COVID. And in the last couple months this has become much more apparent, much more clear. This was a really big study, done again using the database of the US Department of Veteran Affairs looking at 153,000 persons with COVID compared to nearly 10 million controls. What they found was that the risk of major cardiovascular events after COVID-19 were extremely high, so the risk of stroke, the risk of TIA [transient ischemic attack], cerebrovascular disorders, dysrhythmias like A-fib, sinus tachycardia. We can see on the right here the hazard ratios for all of these. Pericarditis, myocarditis, acute coronary disease, MI, ischemic cardiomyopathy, angina and the list goes on and on and on. Pulmonary embolism and DVT. Superficial vein thrombosis. They were all much higher in patients up to one year after COVID-19 and they broke it down even a little bit further, George. What they looked at was they broke it down by non-hospitalized, hospitalized, in ICU. And not surprisingly, the risk of these bad cardiovascular events occurring in patients, were, in the ICU, the highest. But when we even look at non hospitalized people, we can see that they're at increased risk compared to historical controls of every single one of these conditions minus cardiac arrest and cardiogenic shock. But when we think about thrombotic disorders, PE, DVT, superficial vein thrombosis. So, these are patients who are not hospitalized, so mild COVID-19 are at increased risk for these types of thrombotic events after COVID- 19. When we look at things like coronary disease, MI, stroke, this is quite scary for patients who did not have a very serious case and really sort of points to us that there might really be a major problem going on with some type of abnormal coagulation post and acute COVID-19. And this was backed up by another study that came out of Sweden that really showed the same thing that there was increased risk of acute myocardial infarction and stroke after COVID-19. So, George, I think when you look at the summary of evidence that we've seen, it is quite clear that Long COVID is associated with prothrombotic state, but everybody after COVID-19 is that some increased risk of a major type of thrombotic event. We need to be monitoring for that. Mr. Fritsma: Fritsma: OK, so in terms of Long COVID, does vaccination impact the risk of post COVID sequelae and Long COVID? Dr. Henry: Henry: This is a really important question and one I've asked quite frequently. The overall evidence to date has been mixed, but I would say the majority of evidence really suggests that the risk of Long COVID is indeed reduced in vaccination by, say, about half. But when we consider the number of breakthrough infections that we've seen in the last several months, we're talking probably about 100 million Americans and more that were