|The following article features coverage from the European Society of Medical Oncology (ESMO) Congress 2021. Click here to read more of Hematology Advisor’s conference coverage.|
Among patients with cancer, COVID-19 infection may lead to life-threatening thromboembolic events (TEs) even after acute illness, necessitating risk prediction tools for TEs, according to research presented at the European Society of Medical Oncology (ESMO) Congress 2021.
While it has previously been established that COVID-19 infection may increase the risk of TEs, it was unknown whether patients with cancer face a greater risk of a TE with COVID-19 than the general population. For this retrospective study, researchers evaluated data from the first COVID-19 pandemic wave to determine prognostic factors for TEs during and after viral infection among a population of patients with cancer.
Overall, data from 219 patients with cancer were included. TEs occurred in 13% of patients in the overall cohort, with a median time from COVID-19 diagnosis to TE of 12 weeks. Just over half (52%) of TEs were noted while the patient was hospitalized for COVID-19; 48% of TEs were reported over the following 12 months. Among patients with a TE, 68% had a pulmonary embolism, 16% had a deep vein thrombosis, and 16% had a different arterial thrombosis.
The overall mortality rate was 52% among patients with a TE vs 41% among patients without a TE, though this difference was not significant. Patients who developed a TE during hospitalization for COVID-19, however, had inferior overall survival (12 weeks vs 52 weeks among patients who were not hospitalized; P =.02).
Multivariate analysis suggested that serum ferritin levels of greater than 296 ng/mL were predictive of TE. Acute respiratory distress syndrome, metastatic cancer, poor performance status, and history of TE were predictive of poorer survival; thromboprophylaxis during hospitalization for COVID-19 predicted improved survival.
“TE in COVID-19[-infected patients with cancer] can lead to fatal outcomes,” the authors wrote. “Thrombotic risk may persist after acute infection; therefore, routine active surveillance should be considered. Larger studies are needed for developing a risk prediction tool for TE in COVID-19[infected patients with cancer].
Pertejo A, Martinez Recio S, Jimenez-Bou D, et al. Thromboembolic disease in COVID-19 cancer patients: Impact on overall survival and prognostic factors. Presented at: European Society of Medical Oncology (ESMO) Congress 2021; September 16-21, 2021. Abstract 1582P.