Clinical characteristics and risk factors for mortality in cancer patients with COVID-19

Abstract

Patients with cancer are at increased risk of severe infections. From a cohort including 3060 patients with confirmed COVID-19, 109 (3.4%) cancer patients were included in this study. Among them, 23 (21.1%) patients died in the hospital. Cancer patients, especially those with hematological malignancies (41.6%), urinary carcinoma (35.7%), malignancies of the digestive system (33.3%), gynecological malignancies (20%), and lung cancer (14.3%), had a much higher mortality than patients without cancer. A total of 19 (17.4%) cancer patients were infected in the hospital. The clinical characteristics of deceased cancer patients were compared with those of recovered cancer patients. Multivariate Cox regression analysis indicated that a Nutritional Risk Screening (NRS2002) score≥3 (adjusted hazard ratio (HR) 11.00; 95% confidence interval (CI) 4.60–26.32; P <0.001), high-risk type (adjusted HR 18.81; 95% CI 4.21–83.93; P <0.001), tumor stage IV (adjusted HR 4.26; 95% CI 2.34–7.75; P <0.001), and recent adjuvant therapy (<1 month) (adjusted HR 3.16; 95% CI 1.75–5.70; P <0.01) were independent risk factors for in-hospital death after adjusting for age, comorbidities, D-dimer, and lymphocyte count. In conclusion, cancer patients showed a higher risk of COVID-19 infection with a poorer prognosis than patients without cancer. Cancer patients with high-risk tumor, NRS2002 score≥3, advanced tumor stage, and recent adjuvant therapy (<1 month) may have high risk of mortality.

Keywords

cancer / COVID-19 / SARS-CoV-2 / risk factor / mortality

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Acknowledgements

We thank all patients involved in the study. This work was supported by the State Key Project on Infectious Diseases of China (No. 2018ZX10723204-003), the National Natural Science Foundation of China (Nos. 81874065 and 81874149), and the Hepato-Biliary-Pancreatic Cancer Investigation Fund of Chen Xiao-ping Foundation for the Development of Science and Technology of Hubei Province (No. CXPJJH11800001-2018356).

Compliance with ethics guidelines

Junnan Liang, Guannan Jin, Tongtong Liu, Jingyuan Wen, Ganxun Li, Lin Chen, Wei Wang, Yuwei Wang, Wei Liao, Jia Song, Zeyang Ding, Xiao-ping Chen, and Bixiang Zhang declare no competing financial interests. The study protocol was approved by the Institutional Review Board of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (Wuhan, China) (Approval No.TJ-IRB20200408).

Electronic Supplementary Material

Supplementary material is available in the online version of this article at https://doi.org/10.1007/s11684-021-0845-6 and is accessible for authorized users.

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