Cancer, Mortality, and Acute Kidney Injury among Hospitalized Patients with SARS-CoV-2 Infection

Abstract

Background: To evaluate Coronavirus Disease 2019-(COVID19) patients treated within our academic medical system to determine if history of malignancy, both in general and specifically in genitourinary oncology patients, is associated with adverse clinical outcomes, including acute kidney injury (AKI) and mortality. Methods: We conducted a retrospective cohort study among patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a multi-hospital, academic medical institution in New York City. Outcomes included mortality, intensive care unit (ICU) admission and AKI among hospitalized patients. We also evaluated risk of hospitalization among all patients with SARS-CoV-2 infection. Multilevel logistic regression models were used for analysis. Results: We identified 6,893 patients who met inclusion criteria, of which 4,018 were hospitalized. Among hospitalized patients 374 (9%) had a history of cancer, 281 (7%) experienced AKI, and 1,045 (26%) died. In adjusted analyses, patients with a history of cancer had 1.33 (95% CI = 1.05, 1.69) times the odds of death compared to those without cancer and this appeared to be driven by lung cancer (odds ratio (OR) = 2.44, 95% CI= 1.05, 4.39). Patients with a history of genitourinary cancer were not at higher risk of mortality compared to those without cancer (OR=0.99, 95% CI= 0.61, 1.62). History of cancer was not associated with ICU admission or AKI in overall and subgroup analyses. Conclusions: Patients with a history of cancer who are hospitalized with SARS-CoV-2 infection are not at greater risk for AKI, though they are at higher risk for mortality as compared to patients without a history of cancer. The increased risk in mortality appears driven by patients with pulmonary neoplasms. Patients with a history of genitourinary malignancies do not appear to be at higher risk for AKI or for mortality compared to the general population.

COVID-19 and Lung Cancer Survival: An Updated Systematic Review and Meta-Analysis

“…The initial search retrieved 171 articles for review ( Figure 1 ). After the inclusion of records that were identified through additional sources and the removal of duplicate articles, a total of 29 studies [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] were included in this systematic review and meta-analysis. Except for the series by Wang et al, which included patients who received anti-COVID vaccines, all other series had their observation period in the pre-vaccine months.…”

“…Nine studies [ 13 , 17 , 23 , 24 , 25 , 27 , 31 , 36 , 37 ] reported the risk of severe infection (life-threatening or requiring ICU admission/mechanical ventilation) in patients with lung cancer compared to non-lung cancer patients. Lung cancer diagnosis increased the risk of severe disease (HR = 1.47 [95%CI1.06, 2.03], p = 0.02; Figure 3 ).…”

Kidney health in the COVID-19 pandemic: An umbrella review of meta-analyses and systematic reviews

“…While the difference could partially be explained by the heterogeneities in region or patient population, other possibilities might also contribute, such as different AKI diagnostic criteria used (biochemical or coded diagnosis), hospital setting (academic center or regional hospital) and the specific definitions of relevant terms (such as baseline creatinine) ( 49 , 50 ). As the pandemic goes on, the health-care community gained better understanding on the disease and are more sophisticated in treatment which might contribute to a drop of AKI and RRT rates over time ( 51 , 52 ). More importantly, different research groups recently reported Omicron demonstrated lower replication in lower airway organoids, lung cells and gut cells.…”

Clinical Efficacy of an Osmotic, Antiviral and Anti-Inflammatory Polymeric Nasal Film to Treat Covid-19 Early-Phase Respiratory Symptoms

“…The main reason behind this sudden and severe systemic pathogenesis is not yet clear as in addition to the severe pulmonary "cytokine storm" 12,13 a novel hematological syndrome manifested as vascular endothelial damage, complement activation, and thrombosis, seriously compromising circulatory functions is also gaining strong acceptance 15 Vascular damage leading to pulmonary hypertension, chronic obstructive pulmonary disease, congestive heart failure, myocardial injury, and pulmonary embolism is postulated to generate respiratory syndrome. 16 Other pathological or malignant conditions, not affecting pulmonary functions, do not appear to affect Covid-19 prompted mortalities. 17 Just after virus infection in the nasal cavity, virus multiplies vigorously in the nasal mucosa, destroys cells and liberates huge quantities of free virus particles on the nasal surface.…”