López-Jiménez Carlos, Gutiérrez Ana, Juliao Caamaño David Salomón, Soto Alsar Javier, Catoya Villa Juan Luis, Blanco Abad Carmen, Morón Blanca, Ortega Morán Laura, Martín Miguel, Muñoz Martín Andrés Jesús
Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Calle del Dr. Esquerdo, 46, 28007, Madrid, Spain.
Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
Clin Transl Oncol. 2025 Feb;27(2):756-769. doi: 10.1007/s12094-024-03635-w. Epub 2024 Aug 2.
To determine the incidence of VTE and clinical outcomes in a cohort of cancer patients and COVID-19 infection, and to establish possible predictive factors of VTE.
METHODS/PATIENTS: A single-center retrospective cohort study was performed to determine the incidence of VTE and mortality in 118 cancer patients with SARS-CoV-2 infection from March to August 2020. We calculated individual Khorana Risk and CATS-MICA scores in order to evaluate their utility to identify risk of VTE or death. Continuous variables were compared using Wilcoxon or Student's T test, and categorical variables were compared using the Chi-Square or Fisher's exact text among patients with and without VTE. A Log-Rank test was performed to detect mortality differences between the groups.
A total of 118 patients were included. VTE global incidence was 4.2% (n = 5), and mortality 25.4% (n = 30). Obesity (p = 0.05), recent chemotherapy (p = 0.049) and use of steroids (p = 0.006) were related to higher risk of VTE in the univariate analysis, although they were not confirmed in the multivariate analysis as independent risk factors. Statistically significant differences in all-cause, COVID-19-related and cancer-related mortality according to the Khorana risk score (KRS) were observed. CATS-MICA score (CMS) also showed statistically significant differences in mortality between low- and high-risk patients. Prediction of risk of VTE development with these scores showed a tendency towards significance.
In this cohort, VTE incidence was similar to previously reported in the general population with SARS-CoV-2 infection. KRS was associated with overall and specific-cause mortality, and might be a useful prognostic tool in this setting.
确定一组癌症患者合并新型冠状病毒肺炎（COVID-19）感染时静脉血栓栓塞症（VTE）的发生率及临床结局，并确定VTE可能的预测因素。
方法/患者：进行了一项单中心回顾性队列研究，以确定2020年3月至8月期间118例感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的癌症患者中VTE的发生率和死亡率。我们计算了个体的科纳纳风险评分（Khorana Risk）和CATS-MICA评分，以评估其识别VTE或死亡风险的效用。连续变量采用Wilcoxon检验或学生t检验进行比较，分类变量采用卡方检验或Fisher精确检验在有或无VTE的患者中进行比较。采用对数秩检验检测组间死亡率差异。
共纳入118例患者。VTE总体发生率为4.2%（n = 5），死亡率为25.4%（n = 30）。在单因素分析中，肥胖（p = 0.05）、近期化疗（p = 0.049）和使用类固醇（p = 0.006）与VTE风险较高相关，尽管在多因素分析中它们未被确认为独立危险因素。根据科纳纳风险评分（KRS）观察到全因、COVID-19相关和癌症相关死亡率存在统计学显著差异。CATS-MICA评分（CMS）在低风险和高风险患者的死亡率方面也显示出统计学显著差异。用这些评分预测VTE发生风险显示出显著趋势。
在该队列中，VTE发生率与先前报道的感染SARS-CoV-2的普通人群相似。KRS与总体及特定原因死亡率相关，可能是该情况下有用的预后工具。
