Abstract 17645: Burden, Disparities, and Predictors of Major Adverse Cardiovascular and Cerebrovascular Events in Cancer Patients Hospitalized with COVID-19 in 2020

BACKGROUND: COVID-19 patients are at higher risk of major adverse cardiovascular and cerebrovascular events (MACCE). The underpinning effect of cancer in COVID-19 enhances this risk. Currently, we have limited nationwide data on MACCE events in cancer patients hospitalized with COVID-19. This study aims to identify demographic and clinical predictors of MACCE in this population. METHODS: We identified COVID-19-hospitalized cancer patients using the 2020 National Inpatient Sample. MACCE, inpatient mortality, and baseline demographics and comorbidities were assessed. Predictors of MACCE were calculated using multivariable regression analysis. RESULTS: Of 68,755 cancer patients hospitalized with COVID-19, 24% had MACCE, and 20.4% died in the hospital, with both outcomes being more significant among males, Asian or Pacific Islanders, and those in the fourth income quartile (all p<0.05). Comorbidities exhibited statistically significant associations for MACCE (all p<0.05). Higher adjusted odds of MACCE were found in age groups >65 (OR 4.17; 95% CI 2.94-5.91) and 45-64 (OR 1.77; 95% CI 1.26-2.48) than 18-44 years, self-paying patients (OR 2.15) than Medicare, urban non-teaching (OR 1.25) and urban teaching hospitalizations (OR 1.24) than rural, prior MI (OR 1.36; 95% CI 1.11-1.66), CKD (OR 1.37; 95% CI 1.22-1.54), severe sepsis (OR 2.75; 95% CI 2.42-2.13), respiratory failure (OR 2.67; 95% CI 2.41-2.96), and mechanical ventilation (OR 12.15; 95% CI 10.40-14.21). Compared to the Northeast, hospitals in the Midwest, West, and South had lower odds of MACCE. Obesity, tobacco use, hyperlipidemia, and prior chemotherapy also exhibited lower odds of MACCE (all p<0.05) (Table. 1). CONCLUSION: Our study using contemporary large-scale data found a concerning burden and higher risk of MACCE, particularly in the elderly, patients with CKD, prior MI, severe sepsis, respiratory failure, and mechanical ventilation.