Abstract
Abnormal coagulation parameters and potential benefits of anticoagulant therapy in general population with novel coronavirus pneumonia (COVID-19) have been reported. However, limited data are available on cancer patients. Coagulation indexes and inflammation parameters in 57 cancer patients with SARS-CoV-2 infection with different severity were retrospectively analyzed. We found that D-dimer levels were increased in 33 patients (57.9%, median: 790 ng/mL). Compared with ordinary type patients, severe and critical ill patients had decreased MPV values (P = 0.006), prolonged PT (median: 13.3 vs. 11.5 vs. 11.4 s, P < 0.001), significant higher D-dimer levels (median: 2,400 vs. 940 vs. 280 ng/mL, P < 0.001), higher PCT levels (median: 0.17 vs. 0.055 vs. 0.045 ng/mL, P = 0.002), higher IL-6 (median: 20.6 vs. 2.3 vs. 3.0 pg/mL, P = 0.040), and decreased PaO2 (median: 68 vs. 84 vs. 96 mm Hg, P < 0.001). Importantly, three patients, one severe and two critical ill type, with increased D-dimer survived after anticoagulant therapy with continuous heparin infusion. Increased D-dimer levels positively correlated with increased PCT levels (r = 0.456, P = 0.002) and IL-6 levels (r = 0.501, P = 0.045). A negative correlation between D-dimer levels and PaO2 levels (r = −0.654, P = 0.021) were also existed. Cancer patients with COVID-19 showed prominent hypercoagulability associated with severe inflammation, anticoagulation therapy might be useful to improve the prognosis and should be immediately used after the onset of hypercoagulability.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused pandemic outbreak all over the world
Fifty-seven cancer patients with COVID-19 were included in our study
COVID-19 is a highly infectious disease with a long incubation period, and it has a variety of clinical manifestations, which has a significant impact on public health and life
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused pandemic outbreak all over the world. Hypercoagulability Among Cancer With COVID-19 harbored a higher risk of SARS-CoV-2 infection and had poorer outcomes than patients without cancer [7, 8]. Researches have validated that abnormal coagulation parameters are closely associated with severity of coronavirus disease 2019 (COVID19) [9,10,11], and anticoagulants can reduce mortality of COVID patients [12]. Details of coagulation state and its association with the severity of disease especially inflammation state in cancer patients with SARS-CoV-2 infection remain poorly understood. Considering the high incidence and damage of cancer-related hypercoagulability, we investigated the clinical significance of coagulation indexes and related parameters and the role of anticoagulant therapy in cancer patients with SARS-CoV-2 infection for the first time in this study
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