ABSTRACT
Introduction: Venous (VTE) and arterial thromboembolic events are one of the most common complications in the Sars-Cov2 infection. Incidence of these complications ranges from 5% to 45%, as found among studies. Cancer is an established risk factor of thromboembolic events. However, it is not well known the incidence of thromboembolic events among cancer patients with COVID-19. Aim: To determine the incidence of venous and arterial thromboembolic complications between hospitalized cancer patients with covid-19. Materials and Methods: We performed a retrospective analysis of cancer patients with COVID-19 admitted to “Gregorio Marañón General University Hospital” from March to June 2020. Eligibility criteria required a positive polymerase chain reaction or IgG/IgM serology test for Sars-Cov2. The main objective is to obtain the incidence of thrombosis between hospitalized cancer patients with COVID-19. The secondary objective is to determine the mortality. Results: We included 79 patients, 64.6% male, with a mean age of 67.9 years old (range 31-94). The median follow-up of the patients was 110 days. Seventy-one patients (89.9%) had active cancer and 72.2% received oncology treatment in the previous 3 months. Sixty-six patients (83.5%) received therapeutic or prophylactic anticoagulation. Baseline characteristics of the patients are summarised in Table 1 overleaf. Five patients (6.3%) suffered a venous thrombosis, and no episodes of arterial thromboembolic events were reported at the end of the study. 3 patients (60%) developed a pulmonary embolism and 2 patients (40%) a deep venous thrombosis. Thirty patients died: 17 patients (56.7%) because of Covid-19, 10 patients (33.3%) due to tumour progression and 3 patients (10%) as a result of other causes. Mortality rate did not significantly differ among patients who developed thrombosis: 38% non-thrombosis vs 33.3% thrombosis;p=0.684. Conclusions: In our study the incidence of venous thromboembolic events among cancer patients with Covid-19 was found to be 6.3% and no arterial thromboembolic event was noticed. This figure is similar to the incidence reported in general population. Mortality was not higher among patients with thromboembolic events. (Table presented.)
ABSTRACT
Background : A recent meta-analysis found a strong relationship between COVID-19 and venous thromboembolism (VTE) in hospitalized patients. Findings on cancer patients and VTE risk remain controversial, mostly in outpatient setting. CATS-MICA score (CMS) was developed as a simple tool (normogram), with only two variables (tumor-site and D-dimer concentration), to calculate predicted 6 month risk of venous thromboembolism (P6RV). Aims : Assessing the prediction capability of VTE risk in SARS-CoV-2-infected cancer patients (inpatients and outpatients) using CMS normogram. Methods : We performed an observational, retrospective, singlecenter study. Consecutive SARS-CoV-2-infected cancer patients attended in Hospital General Universitario Gregorio Marañón Madrid, Spain, in the first wave from March 2020 to June 2020, were included in the analysis. According to tumor location and D-Dimer value, CMS was individually calculated based on the online risk calculator (available at http://catsc ore.medun iwien.ac.at/ ) at COVID-19 diagnosis. Data were collected from electronic medical records. Results : 80 patients were included (Table 1). Median follow-up was 117 days. There was no statistically significant association between CMS and VTE (median CMS for VTE patients was 6.18% and for non VTE patients was 4.93%, P = 0.6). There was a statistical significant difference between the CMS of death cases and survivors . Survival analysis (Figure 1) showed a significant difference between low (<5%) and high (≥5%) risk groups ( P 0.02). Conclusions : Limitations such as sample size and heterogeneity, plus use of anticoagulation on most patients at the moment of COVID-19 diagnosis blur the results. Further studies are required to demonstrate the usefulness of the CMS for prediction of VTE in this specific setting. Regardless, there were significant differences in mortality between high and low risk groups of P6RV values at survival analysis, suggesting a valuable relationship between this tool and mortality, that could be more thoroughly investigated.