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

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.

Approach to Thromboprophylaxis for Prevention of Venous Thromboembolism in COVID-19: Global Updates and Clinical Insights from India

“…However, due to limited evidence and a high risk of bleeding and thrombosis, a vigilant benefit–risk assessment is necessary when deciding the treatment for these patients. In addition, it is imperative to consider the assessment of the dose and duration of the anticoagulation regimen to secure better clinical outcomes in these patients [ 85 ]. A detailed consideration of the duration of prophylaxis and delay of chemotherapy (often 14–28 days) post-COVID-19 is also vital in cancer patients.…”