Venous Thrombotic Complications in Cancer Patients with SARS-CoV-2 Infection: Report from the COVID-19 and Cancer Consortium (CCC19) Registry Analysis

R. Rosovsky¹, A. Li², A. Desai³, D. Shah⁴, J. Fu⁵, S. Gulati⁶, R. Zon⁷, M. Thompson⁸, P. Grivas⁹, G. de Lima Lopes¹⁰, Y. Shyr¹¹, J. Warner¹¹, A. Khaki⁹, T. Choueiri¹², S. Peters¹³, D. Rivera¹⁴, B. Rini¹¹, G. Lyman¹⁵, J. Connors¹⁶, N. Kuderer¹⁷, on behalf of the COVID-19 and Cancer Consortium (CCC19)

¹Massachusetts General Hospital and Harvard Medical School, Boston, United States, ²Baylor College of Medicine, Houston, United States, ³University of Connecticut, Farmington, United States, ⁴Mays Cancer Center at UT Health San Antonio MD Anderson, San Antonio, United States, ⁵Tufts Medical Center, Boston, United States, ⁶University of Cincinnati, Cincinnati, United States, ⁷Brigham and Women's Hospital, Boston, United States, ⁸Advocate Aurora Health, Milwaukee, United States, ⁹University of Washington, Seattle, United States, ¹⁰University of Miami, Miami, United States, ¹¹Vanderbilt University Medical Center, Nashville, United States, ¹²Dana Farber Cancer Institute, Boston, United States, ¹³Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland, ¹⁴National Cancer Institute, Rockville, United States, ¹⁵Fred Hutchinson Cancer Research Center, Seattle, United States, ¹⁶Brigham and Women's Hospital and Harvard Medical School, Boston, United States, ¹⁷Advanced Cancer Research Group, Kirkland, United States

Abstract Number: PB/CO07

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » Cancer Associated Thrombosis

Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality in patients with cancer. Patients with COVID-19, especially those admitted to the intensive care unit (ICU), are also reported to have increased risk of VTE. Data investigating VTE in patients with both cancer and COVID-19 are limited.

Aims: The COVID-19 and Cancer Consortium (CCC19) (NCT04354701) international cohort study aimed to investigate the clinical course and complications of SARS-CoV-2 in patients with cancer.

Methods: Chart review was used to identify endpoints including incident VTE stratified by high risk subgroups, initial COVID-19 severity, and cancer treatment status.

Results: From March 17, 2020 to May 16, 2020, 2199 patients were accrued with 58% of patients greater than 2-weeks follow-up. Median age was 67 (18-89) and 50.5% were men. While all COVID-19 patients had current or past history of cancer (1741 solid; 458 hematologic), only 55% received anti-cancer therapy in preceding 3 months. Initial COVID-19 severity was mild (outpatient), moderate (hospitalization), and severe (ICU) in 42%, 43%, and 12% of patients, respectively, with 3% unknown. VTE complications occurred in 3.5% of all patients. Among these, 1.3% (12/931), 4.2% (39/936), and 10.0% (26/260) occurred in outpatient, non-ICU hospitalization, and intensive care setting, respectively. Furthermore, VTE was more frequent in patients receiving any recent anti-cancer therapy than those without (5.2% vs. 2.2%) and in patients with progressive disease compared to those in remission/NED (7.1% vs 2.0%). The results reported here are likely an underestimate of true incidence given limited follow-up to date. Data collection is currently ongoing; a detailed assessment of pre-specified cancer subgroups with increased susceptibility for VTE will be presented. Continued follow-up assessment is required for formal VTE risk prediction.

Conclusions: Our study is the largest cancer cohort to date describing the incidence of VTE in COVID-19 patients. Results will inform global thrombosis care in this population.

To cite this abstract in AMA style:

Rosovsky R, Li A, Desai A, Shah D, Fu J, Gulati S, Zon R, Thompson M, Grivas P, de Lima Lopes G, Shyr Y, Warner J, Khaki A, Choueiri T, Peters S, Rivera D, Rini B, Lyman G, Connors J, Kuderer N, on behalf of the COVID-19 and Cancer Consortium (CCC19) . Venous Thrombotic Complications in Cancer Patients with SARS-CoV-2 Infection: Report from the COVID-19 and Cancer Consortium (CCC19) Registry Analysis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/venous-thrombotic-complications-in-cancer-patients-with-sars-cov-2-infection-report-from-the-covid-19-and-cancer-consortium-ccc19-registry-analysis/. Accessed November 30, 2023.

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