Cats-mica score in predicting venous thromboembolism in SARS-CoV-2-infected cancer patients

Background : A recent meta-analysis found a strong relationship between COVID-19 and venous thromboembolism (VTE) in hospitalized patients. Findings on cancer patients and VTE risk remain controversial, mostly in outpatient setting. CATS-MICA score (CMS) was developed as a simple tool (normogram), with only two variables (tumor-site and D-dimer concentration), to calculate predicted 6 month risk of venous thromboembolism (P6RV). Aims : Assessing the prediction capability of VTE risk in SARS-CoV-2-infected cancer patients (inpatients and outpatients) using CMS normogram. Methods : We performed an observational, retrospective, singlecenter study. Consecutive SARS-CoV-2-infected cancer patients attended in Hospital General Universitario Gregorio Maranon Madrid, Spain, in the first wave from March 2020 to June 2020, were included in the analysis. According to tumor location and D-Dimer value, CMS was individually calculated based on the online risk calculator (available at http://catsc ore.medun iwien.ac.at/ ) at COVID-19 diagnosis. Data were collected from electronic medical records. Results : 80 patients were included (Table 1). Median follow-up was 117 days. There was no statistically significant association between CMS and VTE (median CMS for VTE patients was 6.18% and for non VTE patients was 4.93%, P = 0.6). There was a statistical significant difference between the CMS of death cases and survivors . Survival analysis (Figure 1) showed a significant difference between low (<5%) and high (≥5%) risk groups ( P 0.02). Conclusions : Limitations such as sample size and heterogeneity, plus use of anticoagulation on most patients at the moment of COVID-19 diagnosis blur the results. Further studies are required to demonstrate the usefulness of the CMS for prediction of VTE in this specific setting. Regardless, there were significant differences in mortality between high and low risk groups of P6RV values at survival analysis, suggesting a valuable relationship between this tool and mortality, that could be more thoroughly investigated.