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. 2022 Aug 11;6(5):e12752.
doi: 10.1002/rth2.12752. eCollection 2022 Jul.

Patients with myeloproliferative neoplasms and COVID-19 have increased rates of arterial thrombosis

Orly Leiva  1   2 , Umberto Campia  3 , Julia Snyder  3 , Briana M Barns  3 , Samantha Rizzo  3 , Candrika D Khairani  3 , Andrew Brunner  4 , Hanny Al-Samkari  4 , Rebecca Karp Leaf  4 , Rachel Rosovsky  4 , Katayoon Goodarzi  4 , Larissa Bornikova  4 , Amir Fathi  4 , Samuel Z Goldhaber  3 , Gabriela Hobbs  4 , Gregory Piazza  3
Affiliations

Patients with myeloproliferative neoplasms and COVID-19 have increased rates of arterial thrombosis

Orly Leiva et al. Res Pract Thromb Haemost. .

Abstract

Background: Both coronavirus disease-2019 (COVID-19) and myeloproliferative neoplasms (MPNs) are associated with systemic inflammation and risk of thrombosis. Risk of thrombosis in patients with COVID with and without MPNs has not been extensively studied.

Methods: Retrospective cohort study of 44 patients with MPNs and 1114 patients without MPNs positive for SARS-COV-2. Outcomes were arterial thrombosis (AT), venous thromboembolism (VTE), bleeding, and death. Time-to-event analysis was performed using competing risk regression model and Cox proportional hazards.

Results: AT occurred more frequently in patients with MPN (7% vs. 1%, p = 0.03). Rates of VTE (7% vs. 5%, p = 0.73), bleeding (7% vs. 2%, p = 0.06), and death (9% vs. 6%, p = 0.32) were similar. MPN patients were older and had more cardiovascular comorbidities. After time-to-event competing-risk regression adjusting for age, MPN patients had higher risk of AT (subdivision hazards ratio 3.95, 95% CI 1.09-14.39) but not VTE, bleeding, or death.

Conclusions: Among patients with COVID-19, MPN patients had higher risk of arterial thrombosis but not VTE, bleeding, and death compared with non-MPN patients. Larger studies are needed to confirm our findings given the limited sample size.

Keywords: COVID‐19; arterial thrombosis; coronavirus; myeloproliferative neoplasms.

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Figures

FIGURE 1
FIGURE 1
Cumulative incidence of thrombotic, bleeding, and survival outcomes in patients with COVID‐19 with and without MPN. Cumulative incidence graphs of arterial thrombosis (A), VTE (B), and bleeding (C). Survival Kaplan–Meier curve of overall survival (D). After competitive risk regression with death as competing risk and adjusting for age, patients with MPN and COVID‐19 have increased incidence of arterial thrombosis compared with non‐MPN patients with COVID‐19 (Fine‐Gray SHR 3.95, 95% CI 1.09–14.39). There was no difference in risk of VTE (Fine‐Gray SHR 0.62, 95% CI 0.15–2.60), bleeding (Fine‐Gray SHR 2.32, 95% CI 0.71–7.59), or all‐cause mortality (Cox HR 0.53, 95% CI 0.19–1.47)
See this image and copyright information in PMC

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