Factors associated with development of an acute ischemic event during hospitalization for COVID-19 in cancer and non-cancer patients

Abstract

BACKGROUND: COVID-19 and solid cancer are both associated with an increased risk of thromboembolism. OBJECTIVES: Assess whether solid cancer is a risk factor for acute ischemic event development among patients with COVID-19. DESIGN: Retrospective cohort SETTING: A tertiary training and research hospital PATIENTS AND METHODS: Patients who were hospitalized for COVID-19 for ≥3 days between 15 March 2020 and 30 March 2021 at Antalya Training and Research Hospital, Antalya, Turkiye. were included in the study. Independent predictors of the development of acute ischemic events during hospitalization were determined using multivariable logistic regression analysis. MAIN OUTCOME MEASURES: Risk factors for acute ischemic event development. SAMPLE SIZE: 538 patients. RESULTS: Patients diagnosed with solid cancer comprised 11.3% of the cohort (n=61). Forty-one (7.6%) developed an acute ischemic event at a median of 3 (range, 1-15) days after hospitalization. The presence of a solid cancer (OR 3.80, 95% CI 1.20-12.03, P=.023) along with length of hospital stay (OR 1.05 per day, 95% CI 1.01-1.09, P=.025) were independent predictors of acute ischemic event development during the course of COVID-19. Mortality was reported in 200 (37%) patients at a median of 5 (range, 3-10) days after hospitalization. The presence of solid tumor increased mortality 5.83 times (95% CI 3.19-10.63, P<.001) while this ratio was 4.59 (95% CI 2.29-9.23, P<.001) for patients who experienced an acute ischemic event. CONCLUSION: Patients with active cancer carry a significant risk for acute ischemic event development during the course of COVID-19 and such patients may require particular attention in terms of anticoagulation therapy. LIMITATIONS: Retrospective design and small sample size. CONFLICT OF INTEREST: None.