TY - JOUR
T1 - Characterization of coagulopathy and outcomes in cancer patients with severe COVID -19 illness
T2 - Longitudinal changes in hospitalized cancer patients
AU - Madani, Mahsa
AU - Goldstein, Drew
AU - Stefanescu, Roxana
AU - Woodman, Scott E.
AU - Rojas-Hernandez, Cristhiam M.
N1 - Funding Information:
This study was funded by the Office of Research and Sponsored Programs of Burrell College of Osteopathic Medicine, Las Cruces, NM and a grant from the American Osteopathic Association (Grant No.: 19137759).
Funding Information:
Anastasia Turin and Data-Driven Determinants of COVID-19 Oncology Discovery Effort (D3CODE) Team at the University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Publisher Copyright:
© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
PY - 2022/10
Y1 - 2022/10
N2 - There is a lack of data focused on the specific coagulopathic derangements in COVID-19 versus non-COVID-19 acutely ill cancer patients. Our objective was to characterize features of coagulopathy in cancer patients with active COVID-19 illness who required hospitalization at MD Anderson in the Texas Medical Center and to correlate those features with thrombotic complications, critical illness, and mortality within the first 30 days after hospital admission for COVID-19 illness. COVID-19 and non-COVID-19 hospitalized cancer patients, with at least five consecutive measures of PT, PTT, d-dimer, and CBC during the same period, were matched 1:1 to perform a retrospective analysis. We reviewed complete blood cell counts with differential, PT, PTT, fibrinogen, D-Dimer, serum ferritin, IL-6, CRP, and peripheral blood smears. Clinical outcomes were thrombosis, mechanical ventilation, critical illness, and death. Compared with matched hospitalized cancer patients without COVID-19, we found elevated neutrophil and lower lymphocyte counts in those with critical illness (p = 0.00) or death (p = 0.00); only neutrophils correlated with thrombosis. COVID-19 cancer patients with a platelet count decline during the hospital stay had more frequent critical illness (p = 0.00) and fatal outcomes (p = 0.00). Of the inflammatory markers, interleukin-6 showed consistently higher levels in the COVID-19 patients with poor outcomes. The findings of unique platelet changes and coagulopathy during severe COVID-19 illness in the cancer population are of interest to explore disease mechanisms and future risk stratification strategies to help with the management of cancer patients with COVID-19.
AB - There is a lack of data focused on the specific coagulopathic derangements in COVID-19 versus non-COVID-19 acutely ill cancer patients. Our objective was to characterize features of coagulopathy in cancer patients with active COVID-19 illness who required hospitalization at MD Anderson in the Texas Medical Center and to correlate those features with thrombotic complications, critical illness, and mortality within the first 30 days after hospital admission for COVID-19 illness. COVID-19 and non-COVID-19 hospitalized cancer patients, with at least five consecutive measures of PT, PTT, d-dimer, and CBC during the same period, were matched 1:1 to perform a retrospective analysis. We reviewed complete blood cell counts with differential, PT, PTT, fibrinogen, D-Dimer, serum ferritin, IL-6, CRP, and peripheral blood smears. Clinical outcomes were thrombosis, mechanical ventilation, critical illness, and death. Compared with matched hospitalized cancer patients without COVID-19, we found elevated neutrophil and lower lymphocyte counts in those with critical illness (p = 0.00) or death (p = 0.00); only neutrophils correlated with thrombosis. COVID-19 cancer patients with a platelet count decline during the hospital stay had more frequent critical illness (p = 0.00) and fatal outcomes (p = 0.00). Of the inflammatory markers, interleukin-6 showed consistently higher levels in the COVID-19 patients with poor outcomes. The findings of unique platelet changes and coagulopathy during severe COVID-19 illness in the cancer population are of interest to explore disease mechanisms and future risk stratification strategies to help with the management of cancer patients with COVID-19.
KW - clinical observations
KW - hematological cancer
KW - prognostic factor
KW - risk assessment
KW - survival
KW - viral infection
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U2 - 10.1002/cam4.4753
DO - 10.1002/cam4.4753
M3 - Article
C2 - 35470980
AN - SCOPUS:85128758380
SN - 2045-7634
VL - 11
SP - 3771
EP - 3785
JO - Cancer medicine
JF - Cancer medicine
IS - 20
ER -