An increased risk of thromboembolic events (TE) is associated with COVID-19 infection. However, information available about thrombosis risk in COVID-19 cancer patients (Ca-P) is still scarce.
We retrospectively evaluated 219 Ca-P who were diagnosed of COVID-19 infection in our institution during the first pandemic wave. The study population was monitored for 12 months, and TE were recorded. A descriptive analysis of baseline and follow-up clinical characteristics was performed. Potential prognostic factors for developing TE and overall survival (OS) were analysed using logistic and cox proportional regression models.
Overall TE rate was 13%. TE were reported during COVID-19 hospitalization (52%) and during follow-up (48%), the median time from COVID-19 diagnosis to TE was 12 weeks (w). Reported TE included pulmonary embolism (68%), deep vein thrombosis (16%), and other arterial thrombosis (16%). Pooled mortality rate among patients with TE was 52%, and 41% among patients without TE. Univariate analysis revealed haemoglobin <10g/dL, D-dimer >3000 ng/mL, PCR >5 ng/mL, LDH >190 UI/L and ferritin > 296 ng/mL during follow-up as significant prognostic factors for TE. Only ferritin > 296 ng/mL remained significant after multivariate analysis. Neither being on any specific oncological treatment nor prior anticoagulant therapy influenced TE risk. No differences in OS were found between patients who developed TE and those who did not. Though, diagnosis of TE during COVID-19 hospitalization conferred poorer survival (12 vs 52 w, p=0.02). Also, being hospitalized for COVID-19 infection was a prognostic factor for worse survival (27 vs 52 w, p=0.03). On multivariate analysis, only acute respiratory distress syndrome, metastatic disease, poor performance status, and history of TE before COVID-19 diagnosis remained significant predictors for poorer survival, and thromboprophylaxis during COVID-19 hospitalization as a predictor for better survival outcomes.
TE in COVID-19 Ca-P can lead to fatal outcomes. Thrombotic risk may persist after acute infection; therefore, routine active surveillance should be considered. Larger studies are needed for developing a risk prediction tool for TE in COVID-19 Ca-P.
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All authors have declared no conflicts of interest.