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Review
. 2022 Mar:6:100098.
doi: 10.1016/j.tru.2022.100098. Epub 2022 Jan 10.

Venous thromboembolism risk, prophylaxis and management in cancer patients with COVID-19: An unmet medical need

Benjamin Brenner  1   2 , Cihan Ay  3   2 , Grégoire Le Gal  4 , Marc Carrier  4 , Andrés J Muñoz  5 , Giancarlo Agnelli  6 , Ana Thereza Cavalcanti Rocha  7 , Hikmat Abdel-Razeq  8 , Ismail Elalamy  9   2 , Anna Falanga  10   11
Affiliations
Review

Venous thromboembolism risk, prophylaxis and management in cancer patients with COVID-19: An unmet medical need

Benjamin Brenner et al. Thromb Update. 2022 Mar.

Abstract

Cancer patients exhibit an increased risk of venous thromboembolism (VTE), with VTE being the second leading cause of morbidity and mortality in these patients. The implementation of lockdowns following the COVID-19 pandemic has resulted in decreased mobility and delayed access to care, thus further increasing the susceptibility to VTE. Cancer patients may also be at a higher risk of SARS-CoV-2 infection and have been shown to be more likely to experience severe COVID-19 disease compared to patients without cancer. Given that both cancer and COVID-19 exhibit a hypercoagulable state, stasis of blood flow, and endothelial injury, cancer patients with COVID-19 constitute a vulnerable population with a high risk of thrombosis and bleeding. However, to date there are limited studies evaluating whether cancer patients infected with SARS-CoV-2 have a higher VTE incidence than COVID-19 patients without cancer, how to assess the risk of VTE, prophylaxis and treatment in this special population. Herein, we highlight the urgent need for studies in cancer patients with COVID-19 to ensure appropriate patient care and improve clinical outcomes.

Keywords: COVID-19; Cancer; Coagulopathy; Thromboprophylaxis; VTE.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Benjamin Brenner received personal fees for participation in advisory boards and for lectures from Bayer, Pfizer, Sanofi, ROVI Pharmaceuticals, and Leo Pharma; honoraria from Hikma pharmaceuticals and Sanofi. Cihan Ay received personal fees for participation in advisory boards and for lectures from Bayer, BMS/Pfizer, Daiichi/Sankyo, and Sanofi. Grégoire Le Gal holds the Chair on Diagnosis of Venous Thromboembolism, Department of Medicine, University of Ottawa and have received a mid-career clinician-scientist award from the Heart and Stroke Foundation of Canada. Marc Carrier received funding for research from BMS, Pfizer, and Leo Pharma and personal fees from Bayer, BMS, Pfizer, Sanofi, Servier, and Leo Pharma. Andrés J. Muñoz is Head of Cancer & Thrombosis Section of the Spanish Society of Medical Oncology (SEOM) and Coordinator of TESEO-SEOM Registry of cancer-associated thrombosis, and received consulting fees from Sanofi, BMS, Leo Pharma, Pfizer, Astrazeneca. Also received honoraria from Rovi, Bayer, Daichii-Sankyo and travel grant from Roche, Amgen and Merck. Giancarlo Agnelli reports personal fees from Werfen, Bristol Myers Squibb, Pfizer, Bayer Healthcare, and Daichi Sankyo outside the submitted work. Ana Thereza Rocha received personal fees for participation in advisory boards and for lectures from Bayer, Daiichi/Sankyo, Boehringer Ingelheim and Sanofi. Hikmat Abdel-Razeq has nothing to report. Ismail Elalamy received research funding and personal fees for participation in advisory boards and for lectures from Bayer, BMS/Pfizer, Leo-Pharma, Aspen, Boehringer Ingelheim, Sanofi and ROVI Pharmaceuticals. Anna Falanga is a full professor of Hematology at the University of Milan Bicocca and Director of the Department of Transfusion Medicine and Hematology in Bergamo, Italy. Received honoraria from Werfen, Stago, Bayer, Leo Pharma, Sanofi and Rovi.

Figures

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Graphical abstract
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