Incidence of thrombosis and hemorrhage in hospitalized cancer patients with COVID-19

An ongoing global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 4.5 million people and resulted in excess of 300 000 deaths worldwide. A pattern of altered coagulation parameters accompanied by a high incidence of thrombotic phenomena characterizes severe coronavirus disease 2019 (COVID-19). Thrombosis in patients with COVID-19 is likely triggered by direct or indirect endothelial injury and subsequent generation of thrombin. The reported rates of thrombosis in patients hospitalized with COVID-19 ranges between 5% to 45% and appears to be influenced by the performance of imaging surveillance, disease severity, and underlying co-morbidities.
Cancer and cancer directed therapies are similarly associated with an increased risk of venous thromboembolism and arterial thrombosis. These risks are exacerbated by acute medical illness and immobilization associated with hospitalization; the incidence of venous thromboembolism (VTE) in hospitalized patients with cancer is considerably higher than the incidence reported in acutely ill medical patients without cancer. Studies have demonstrated poorer outcomes with higher fatality rates in patients with active cancer and COVID-19.15,16 Cancer diagnoses are also an established risk factor for hemorrhage on anticoagulation. The impact of COVID-19 on the incidence of thrombosis or hemorrhage in patients with active malignancy who require hospitalization has not been reported.

Incidence of thrombosis and hemorrhage in hospitalized cancer patients with COVID-19
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