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Incidence of thrombosis and hemorrhage in hospitalized cancer patients with COVID-19 #MMPMID32692862
Patell R; Bogue T; Bindal P; Koshy A; Merrill M; Aird WC; Bauer KA; Zwicker JI
J Thromb Haemost 2020[Sep]; 18 (9): 2349-2357 PMID32692862show ga
BACKGROUND: Coronavirus disease-2019 (COVID-19) is a recognized prothrombotic state. Patients hospitalized with active cancer are predisposed to thrombosis but whether active cancer further amplifies thrombotic risk with COVID-19 is not known. OBJECTIVES: To evaluate cumulative incidences of thrombotic and hemorrhagic events in hospitalized COVID-19 patients with and without active cancer at 28 days. METHODS: A retrospective cohort analysis of consecutive adults hospitalized with COVID-19 was performed. Active cancer required cancer-directed therapy within previous 6 months. The cumulative incidences of thrombosis or hemorrhage were estimated considering death as a competing risk. RESULTS: Patients without cancer (n = 353) and active cancer (n = 45) were comparable in terms of age, sex, antibiotics administered, length of hospitalization, and critical care. The most common malignancies were lymphoid (17.8%), gastrointestinal (15.6%), lung (13.3%), and genitourinary (13.3%). At day 28, the cumulative incidence of thrombotic events was 18.2% (95% confidence interval [CI], 10.2%-27.9%) in the non-cancer cohort and 14.2% (95% CI, 4.7%-28.7%) in the cancer cohort. The cumulative incidence of major and fatal bleeding at day 28 was 20.8% (95% CI, 12.1%-31.0%) in the non-cancer group and 19.5% (95% CI, 5.5%-39.8%) in the cancer cohort. Three patients experienced fatal bleeds, all of whom were in the non-cancer cohort. Survival was significantly shorter in the group with active cancer (P = .038). CONCLUSIONS: We observed a similarly high incidence of thrombosis and bleeding among patients admitted with COVID-19 with or without active cancer.
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J+Thromb+Haemost 2020 ; 18 (9): 2349-2357
