COVID-19 in Relation to Hematological Events (Thrombosis/Bleeding) and Mortality in Inpatient Setting

COVID-19 is a newly diagnosed entity that has been identified for about 6 months. With the US now being the prevalent nation affected, we aimed to identify factors that were relevant to survival and hematological events in COVID patients. Our group had primarily been assessing COVID-19 confirmed patients as per PCR at Ochsner Medical Center in Louisiana; we primarily studied patients who were admitted between January 2020 to May 2020. Our main events that are currently being studied include factors such as mortality, length of stay, and bleeding or thrombotic events. Secondary endpoints included factors such as influence on blood type and also amount of transfusions required by these patients.

Our overall analysis of 1773 patients yielded a number of 60 patients who were able to identify as having an active cancer diagnosis. This disproportionate number of patients may be related to factors such as reluctance to visit the hospital among cancer patients, a phenomenon noted similarly in Cardiology where the number of admissions for cardiac causes had declined suddenly during this pandemic timeline. Our half of our population was African American and included an even proportion of males and females. The age range of patients was between 35-93 years old.

The most common malignancies that were noted to co-occur with COVID-19 in our population seemed to be lung, prostate, and hematological malignancies. Although final analyses regarding mortality are to be completed, the proportion of patients who had died with a diagnosis of cancer was around 50% per collection of our current data. Twenty three out of 60 (38%) patients required blood transfusions. In comparison to other reports which had reported bleeding events and thrombotic events, our report had revealed a much less rate of bleeding events (5/60) and thrombotic events (5/60). We plan to repeat our analysis to assess for any confounders in identifying these events, as noted, since some earlier literature had reported between ¼ to ⅔ of patients having a thrombotic event.

Our analysis also looks at other descriptive variables such as use of anticoagulant and antiplatelet agents, absolute counts of neutrophils and lymphocytes, platelets, and coagulation markers. Also, our assessment includes a study in assessment of any delays noted in chemotherapy dates for these patients. Analysis of assessment of bleeding, thrombosis, and mortality for the entire patient group is currently in process.