Outcome of deep venous thrombosis and pulmonary embolism in COVID-19 cancer patients vs non-cancer patients.

Abstract

e24066 Background: COVID-19 is associated with an increased incidence of venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Multiple mechanisms including COVID-19-induced endothelial dysfunction, cytokine storm, complement activation, and hypoxia lead to the activation of the coagulation cascade. Of note, VTE is the most common presentation of cancer-associated thrombosis. It is associated with worsened prognosis and mortality in both COVID-19 patients and cancer patients. Some studies indicated that comparing to COVID-19 non-cancer population, COVID-19 cancer patients have a higher risk of developing VTE. Methods: This retrospective cohort study identified 1,306 adult patients admitted to the tertiary medical center for COVID-19 treatment from 2020 to 2021, including 38 active cancer patients and 1268 non-cancer patients. Skin cancers were excluded. All patients received anticoagulant for VTE prophylaxis. The primary outcome of interest was the VTE incidence. Results: There was no significant difference in baseline demographics between groups. 35 non-cancer COVID-19 patients developed DVT (2.76%), while one patient had DVT in the cancer group (2.63%); for PE, 25 non-cancer patients were found to have PE (1.97%), while one cancer patient was diagnosed with PE (2.63%). There were no statistical differences in DVT and PE incidences between the COVID-19 cancer group and the non-cancer group during hospitalization. However, the cancer group was found to have older age (P < 0.001), higher D-dimer (P = 0.024) level, and more severe thrombocytopenia (P < 0.001). The COVID-19 cancer group revealed significantly higher in-hospital mortality (36.84%) comparing to the non-cancer group (14.98%) (P < 0.001). Conclusions: Our study revealed no differences in the incidence of PE and DVT between the COVID-19 cancer population and the COVID-19 non-cancer population; COVID-19 cancer patients experienced significantly higher mortality comparing to COVID-19 non-cancer patients. This highlights the importance of having larger-scale studies in the future to assess different outcomes in patients with malignancy and COVID-19.