Bleeding Complications in Patients with Cancer and COVID 19- Analysis from the COVID 19and Cancer Consortium (CCC19) Registry

ABSTRACT

Background: Patients (pts) with COVID-19 are reported to have increased risk of venous thromboembolism yet bleeding has been an under recognized complication. Rates of bleeding remain unexamined in all patients especially in pts with cancer and COVID-19. Aim: To estimate the incidence of bleeding complication in patients with cancer and COVID 19 Methods: The CCC19 international registry (NCT04354701) aims to investigate complications of COVID-19 in pts with cancer. Our aim was to investigate the frequency of bleeding in hospitalized adult pts with cancer andCOVID-19, enrolled between March 16, 2020 and Feb 8, 2021. The incidence of bleeding complications was captured as defined by CCC19 and included both major and non major bleeding. Associated baseline clinic-pathologic prognostic factors and outcomes such as need for mechanical ventilation, intensive care unit (ICU) admission and mortality rates were assessed Results:3849 pts met analysis inclusion criteria. Bleeding was reported in 276 (7%) pts with median age of 70years;incidence was 6.6 % in females and 7.6 % in males, 6.5% in non-Hispanic white pts, 8.2 % in non-Hispanic Black pts, and 7.8 % in Hispanic pts. 74% had solid cancer and 29% had hematologic malignancies, 33% had received anti-cancer therapy in preceding 30 days, and 8% had surgery within 4weeks. In pts taking antiplatelet or anticoagulant medications at baseline, 7.2% developed bleeding. Need for mechanical ventilation, ICU admission, 30-day mortality, and total mortality were significantly higher in those with bleeding complications compared to those without, p<0.05 Conclusion: We describe the incidence of bleeding in a large cohort of pts with cancer and COVID-19. Bleeding events were observed in those with adverse outcomes including mechanical ventilation, ICU admission, and high mortality;the overall mortality of 43% in patients with bleeding complications is especially notable. This important complication may reflect underlying COVID-19 pathophysiology as well as iatrogenic causes. [Formula presented] Disclosures Kumar Diagnostica Stago Honoraria. Zon AMAGMA AND RLZ Consultancy, Current holder of individual stocks in a privately-held company. Byeff Pfizer, BMS, Takeda,Teva, Merck, United health Consultancy, Current equity holder in publicly-traded company, Current holder of stock options in a privately-held company. Nagaraj Novartis Research Funding. Hwang astrazaneca,Merck,bayer, Genentech Consultancy, Research Funding. McKay Myovant Consultancy;Bayer Membership on an entity's Board of Directors or advisory committees;AstraZeneca Consultancy, Membership on an entity's Board of Directors or advisory committees;Exelixis Consultancy, Membership on an entity's Board of Directors or advisory committees;Calithera Membership on an entity's Board of Directors or advisory committees;Tempus Research Funding;Merck Consultancy, Membership on an entity's Board of Directors or advisory committees;Tempus Membership on an entity's Board of Directors or advisory committees;Pfizer Membership on an entity's Board of Directors or advisory committees, Research Funding;Janssen Membership on an entity's Board of Directors or advisory committees;Bristol Myers Squibb Consultancy, Membership on an entity's Board of Directors or advisory committees;Sanofi Membership on an entity's Board of Directors or advisory committees;Novartis Membership on an entity's Board of Directors or advisory committees;Dendreon Consultancy;Caris Other Serves as a molecular tumor board;Vividion Consultancy;Sorrento Therapeutics Consultancy;Bayer Research Funding. Warner Westat, Hemonc.org Consultancy, Current holder of stock options in a privately-held company. Connors Pfizer Honoraria;CSL Behring Research Funding;Alnylam Consultancy;Bristol-Myers Squibb Honoraria;takeda Honoraria;Abbott Consultancy. Rosovsky Janssen Consultancy, Research Funding;BMS Consultancy, Research Funding;Inari Consultancy, Membership on an entity's Board of Directors or advisory committees;Do a Consultancy, Membership on an entity's Board of Directors or advisory committees.