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Background : Venous thromboembolism (VTE) is a common complication in acute COVID-19 and those with hematologic malignancy (HM) may be at an even higher risk. We performed a retrospective analysis of patients with history of HM and acute COVID-19 to evaluate thrombotic and clinical outcomes. Methods : Patients with COVID-19 were identified by positive SARS-CoV-2 PCR test. Our primary endpoints were rate of VTE and CVA in patients with HM compared to the general population (GP). Secondary outcomes included composite thrombotic events (CVA + VTE), COVID-19 fatality, respiratory support, ICU admission rates, and length of ICU stay Results : 833 patients were evaluated, 709 in the GP cohort, 124 patients in the HM cohort. CVA was more prevalent in the HM cohort (5.4% vs. 1.6%, p = 0.011). Rates of VTE were numerically higher for the HM cohort (8.0% vs. 3.6%, p = 0.069). The composite thrombotic rate was increased in the HM cohort (13.4% vs 5.2%, p = 0.005). Patients with HM had a higher inpatient fatality rate (35.5% vs 11.3%, p < 0.001), required more respiratory support (74.6% vs 46.5%, p < 0.001) and had a higher rate of ICU admission (31.9% vs 12.1%, p = 0.001). Conclusion : Our data demonstrated an increased rate of composite thrombotic (CVA + VTE) outcomes, indicating HM patients with acute COVID-19 are at increased risk of thrombosis. Irrespective of disease status, HM patients also have significantly increased need for intensive care, respiratory support, and have higher fatality rates.

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