tetano
Editor, Senior Moderator
Clin Lymphoma Myeloma Leuk
. 2021 Dec 26;S2152-2650(21)02482-4.
doi: 10.1016/j.clml.2021.12.011. Online ahead of print.
Thrombotic and Clinical Outcomes in Patients with Hematologic Malignancy and COVID-19
Michael R Cook[SUP] 1 [/SUP], Kaitlyn Dykes[SUP] 2 [/SUP], Katherine White[SUP] 3 [/SUP], Sameer Desale[SUP] 4 [/SUP], Rajeev Agrawal[SUP] 4 [/SUP], Stephen Fernandez[SUP] 4 [/SUP], Xu Huang[SUP] 4 [/SUP], Nathan K Cobb[SUP] 5 [/SUP], Catherine Lai[SUP] 6 [/SUP]
Affiliations
Abstract
Background: Venous thromboembolism (VTE) is a common complication in acute COVID-19 and those with hematologic malignancy (HM) may be at an even higher risk. We performed a retrospective analysis of patients with history of HM and acute COVID-19 to evaluate thrombotic and clinical outcomes.
Methods: Patients with COVID-19 were identified by positive SARS-CoV-2 PCR test. Our primary endpoints were rate of VTE and CVA in patients with HM compared to the general population (GP). Secondary outcomes included composite thrombotic events (CVA + VTE), COVID-19 fatality, respiratory support, ICU admission rates, and length of ICU stay RESULTS: A total of 833 patients were evaluated, 709 in the GP cohort, 124 patients in the HM cohort. CVA was more prevalent in the HM cohort (5.4% vs. 1.6%, P = .011). Rates of VTE were numerically higher for the HM cohort (8.0% vs. 3.6%, P = .069). The composite thrombotic rate was increased in the HM cohort (13.4% vs. 5.2%, P = .005). Patients with HM had a higher inpatient fatality rate (35.5% vs. 11.3%, P < .001), required more respiratory support (74.6% vs. 46.5%, P < .001) and had a higher rate of ICU admission (31.9% vs. 12.1%, P = .001).
Conclusion: Our data demonstrated an increased rate of composite thrombotic (CVA + VTE) outcomes, indicating HM patients with acute COVID-19 are at increased risk of thrombosis. Irrespective of disease status, HM patients also have significantly increased need for intensive care, respiratory support, and have higher fatality rates.
Keywords: Cerebrovascular accident (CVA); Hematologic malignancy (HM); Outcomes research; Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 or COVID-19); Venous thromboembolism (VTE).
. 2021 Dec 26;S2152-2650(21)02482-4.
doi: 10.1016/j.clml.2021.12.011. Online ahead of print.
Thrombotic and Clinical Outcomes in Patients with Hematologic Malignancy and COVID-19
Michael R Cook[SUP] 1 [/SUP], Kaitlyn Dykes[SUP] 2 [/SUP], Katherine White[SUP] 3 [/SUP], Sameer Desale[SUP] 4 [/SUP], Rajeev Agrawal[SUP] 4 [/SUP], Stephen Fernandez[SUP] 4 [/SUP], Xu Huang[SUP] 4 [/SUP], Nathan K Cobb[SUP] 5 [/SUP], Catherine Lai[SUP] 6 [/SUP]
Affiliations
- PMID: 35058217
- DOI: 10.1016/j.clml.2021.12.011
Abstract
Background: Venous thromboembolism (VTE) is a common complication in acute COVID-19 and those with hematologic malignancy (HM) may be at an even higher risk. We performed a retrospective analysis of patients with history of HM and acute COVID-19 to evaluate thrombotic and clinical outcomes.
Methods: Patients with COVID-19 were identified by positive SARS-CoV-2 PCR test. Our primary endpoints were rate of VTE and CVA in patients with HM compared to the general population (GP). Secondary outcomes included composite thrombotic events (CVA + VTE), COVID-19 fatality, respiratory support, ICU admission rates, and length of ICU stay RESULTS: A total of 833 patients were evaluated, 709 in the GP cohort, 124 patients in the HM cohort. CVA was more prevalent in the HM cohort (5.4% vs. 1.6%, P = .011). Rates of VTE were numerically higher for the HM cohort (8.0% vs. 3.6%, P = .069). The composite thrombotic rate was increased in the HM cohort (13.4% vs. 5.2%, P = .005). Patients with HM had a higher inpatient fatality rate (35.5% vs. 11.3%, P < .001), required more respiratory support (74.6% vs. 46.5%, P < .001) and had a higher rate of ICU admission (31.9% vs. 12.1%, P = .001).
Conclusion: Our data demonstrated an increased rate of composite thrombotic (CVA + VTE) outcomes, indicating HM patients with acute COVID-19 are at increased risk of thrombosis. Irrespective of disease status, HM patients also have significantly increased need for intensive care, respiratory support, and have higher fatality rates.
Keywords: Cerebrovascular accident (CVA); Hematologic malignancy (HM); Outcomes research; Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 or COVID-19); Venous thromboembolism (VTE).