COVID-19 and prevalence of venous thromboembolism among cancer patients: A nationwide inpatient sample analysis.

Authors

null

Muhammad Bilal Ibrahim

John H. Stroger, Jr. Hospital of Cook County, Chicago, IL

Muhammad Bilal Ibrahim , Rafaella Litvin , Hiba Noor , Ali Husnain Khan , Michelle Ishaya , Khaldun Obeidat , Philip Onyekaoso Kanemo , Ayobami Gbenga Olafimihan , Ekrem Turk , Badri Aryal , Muhammad Tayyab Anwar , Aneeza Jamshed , Kunnal Batra

Organizations

John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, Fatima Jinnah Medical University Queens Road Lahore, Lahore, Pakistan, Sahara Medical College, Narowal, Narowal, Pakistan, Rapides Regional Medical Center, Alexandria, LA

Research Funding

No funding received
None.

Background: Cancer, as well as immunosuppression from chemotherapy, aggravates thromboembolism risk. The risk is likely amplified in an additive fashion with COVID-19 infection, which confers a higher risk of VTE risk with viral sepsis, endothelial inflammation, and microthrombi formation. Numerous studies have shown the heightened risk of pulmonary embolism among severe COVID-19 patients. We sought to evaluate further the extent of COVID-19-associated coagulopathy and associated outcomes. Methods: National Inpatient Sample 2020 was used to identify non-elective hospitalizations of patients with a secondary diagnosis of any cancer. These were stratified into two cohorts based on the presence of the primary diagnosis of COVID-19. Primary outcomes include venous thromboembolism, PE, and VTE without PE in cancer patients with and without Covid-19 infection. The secondary outcomes examined were in-patient mortality, the average length of stay (LOS), and total hospital charge (THC). Multivariate analysis was performed to obtain the odds ratio. All weighted analysis was conducted through STATA 17. Results: Out of 1,734,735 non-elective admissions of patients with cancer, 36,295 (2%) were admitted for COVID-19. Our analysis showed statistically non-significant increased odds of venous thromboembolism(aOR:1.09 CI 0.99-1.20) in cancer patients with COVID. There was, however, a significant increase in the odds of pulmonary embolism(aOR 1.7, CI: 1.51- 1.91) among cancer patients with Covid-19. There were decreased odds of VTE without PE(aOR: 0.67 CI: 0.57-0.78). There was a statistically significant increase in odds of mortality (aOR: 2.8 CI: 2.63-3.0), length of stay(aOR:1.85 CI: 1.65- 2.05), total hospital charges($83,201 vs. $78,869 p: < 0.01) in cancer patients with COVID-19 compared to cancer patients without COVID-19. Conclusions: This study shows that COVID-19 in cancer patients has deleterious effects, including an increased risk of pulmonary embolism and poor in-hospital outcomes. The finding of a lower incidence of non-PE VTE in patients with cancer is likely related to limitations with coding in NIS, in which lower complexity codes might be omitted in patients with multiple diagnoses. With significantly increased mortality and economic burden, these findings emphasize the significance of thrombotic prophylaxis and vaccination in cancer patients.

Characteristics Covid +veCovid -veP value
Mean patient age, years (95% CI)70.64 (70.3 -71)67.89( 67.67- 68.1)p: < 0.01
Male, (%)5653p: < 0.01
White,(%)62.4669.93p: < 0.01
Any VTE,( %)6.426.18p: 0.079
Pulmonary embolism,(%)4.082.61p: < 0.01
VTE no PE,( %)2.343.58p: < 0.01)
Mortality(%)17.537.39p: < 0.01
Mean LOS(days)7.98(CI: 7.77- 8.18)6.32(CI: 6.25- 6.38)p: < 0.01
Total charges($)83,201(CI: 78,970- 87,433)78,869(CI: 76,341-81,397)p: < 0.01

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Health Services Research and Quality Improvement

Track

Quality Care/Health Services Research

Sub Track

Real-World Data/Outcomes

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e18839)

DOI

10.1200/JCO.2023.41.16_suppl.e18839

Abstract #

e18839

Abstract Disclosures

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