Effect of COVID-19 on mortality in patients admitted for DVT/PE with pre-existing cancer diagnosis at the beginning of the COVID-19 pandemic: A national inpatient sample study.

Abstract

e18903 Background: Coagulopathy and thrombosis are commonly associated with both cancer and Coronavirus Disease 2019 (COVID-19) infection. Thus, it is thought that cancer patients with COVID-19 carry an even higher risk for thrombosis than each disease individually. Cohort studies using the COVID-19 and Cancer Consortium (CCC19) registry data have identified risk factors for development of in-hospital VTE and PE in patients with cancer and COVID-19, however the risk of in-hospital mortality and length of stay in this population remains unknown. Using newly-available data from the National Inpatient Sample in 2020, we compared rates of in-hospital mortality and length of stay between patients with and without COVID-19 infection admitted for DVT and PE with known diagnosis of cancer. Methods: The National Inpatient Sample was analyzed to identify all adult admissions with primary diagnosis of DVT and PE and secondary diagnosis of solid tumor or hematologic malignancy from April to December 2020. These patients were then stratified based on secondary diagnoses of COVID-19 infection. Rates of inpatient mortality and hospital length of stay were compared to non-COVID patients. The cases for COVID-19 infection, thrombotic events, and cancer were selected based on ICD-10 (International Classification of Disease) codes. ICD-10 codes used for solid tumor malignancies included breast, lung, prostate, colon, pancreas, liver, and rectal cancer. ICD-10 codes for hematologic malignancy included leukemia, lymphoma, and multiple myeloma. Chi square tests were utilized to check the significance of association between mortality, LOS and COVID-19 infection in the population admitted for DVT and PE. Results: There were a total of 13,856 patients admitted for DVT/PE with secondary diagnosis of solid tumor or hematologic malignancy from April to December 2020. Among this population, 80 patients (mean age 61 years) also had a secondary diagnosis of COVID-19 infection. Overall in-hospital death rate for cancer patients with DVT/PE was 5.2% (n = 720). Less than 1% (n = 5) of those patients had a secondary diagnosis of COVID-19 infection (P = 0.8547). Mean LOS with COVID-19 diagnosis was 4 days (95% CI 2.7 - 5.3) and without COVID diagnosis was 4.75 days (95% CI 4.5 - 5, P = 0.4483), showing no statistically significant difference. Conclusions: There was no statistically significant difference of mortality or LOS between COVID-19 and non-COVID-19 infected patients admitted for DVT or PE with secondary diagnosis of malignancy.