Outcomes of venous thromboembolism among cancer patients admitted with COVID-19: A nationwide inpatient sample analysis.

Abstract

e18823 Background: Cancer patients are at a higher risk of venous thromboembolism and fatal pulmonary embolism due to inflammatory cytokines, reduced coagulation inhibitors, microparticles, and other molecular mechanisms. COVID-19 leads to endothelial inflammation and microthrombi formation, further aggravating the baseline profound risk among cancer patients, with subsequent worsened mortality and morbidity. We sought to explore the outcomes of COVID-19-associated VTE in cancer patients. Methods: National Inpatient Sample 2020 was used to identify hospitalizations of cancer patients with COVID-19 with a secondary diagnosis of venous thromboembolism. All cancer patients with COVID-19 were stratified into two cohorts based on the presence of venous thromboembolism. The primary outcomes examined were In-patient mortality, the average length of stay (LOS), and total hospital charge (THC). Multivariate analysis was performed to obtain the odds ratio. All weighted analysis was conducted through STATA 17. Results: Using NIS 2020, 36,285 hospitalizations were identified with cancer and a primary diagnosis of COVID-19. Among cancer patients with COVID-19, the presence of any type of venous thromboembolism was associated with increased mortality(aOR: 1.7 CI: 1.36- 2.11),length of stay(11.62 vs. 7.73 days p < 0.01) and total charges($141,049 vs. $79,238 p < 0.01). Pulmonary embolism was similarly associated with increased mortality (aOR: 1.42 CI: 1.08- 1.88), LOS(9.27 vs. 7.92 days p = 0.015), and total charges($107,111 vs. $82,180 p < 0.01). Venous thromboembolism other than PE was associated with increased mortality at a higher adjusted odds ratio (aOR: 2.12 CI: 1.52- 2.96), as well as longer LOS(15.71 vs. 7.79 days p < 0.01) and higher total charges($200,999 vs. $80,406 p < 0.01). Conclusions: This study shows that venous thromboembolism among cancer patients with COVID-19 leads is associated with increased mortality and economic costs. VTE other than PE appears to be associated with less favorable odds than PE. Physicians should maintain a higher degree of suspicion for venous thromboembolism when treating cancer patients with COVID-19. Optimum thrombotic prophylaxis, timely diagnosis, and treatment of venous thromboembolism are critical to reducing the deleterious outcomes. [Table: see text]