Clinical characteristics, risk factors and outcomes of cancer patients withCOVID‐19: A population‐based study

Abstract

Introduction Cancer patients may be susceptible to poorer outcomes in COVID‐19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions. Methods This was a population‐based retrospective cohort study of COVID‐19 patients who presented to Hong Kong public hospitals between 1 January 2020 and 8 December 2020. The primary outcome was a composite endpoint of requirement for intubation, ICU admission and 30‐day mortality. Results The following study consisted of 6089 COVID‐19 patients (median age 45.9 [27.8.1–62.7] years; 50% male), of which 142 were cancer subjects. COVID‐19 cancer patients were older at baseline and tended to present with a higher frequency of comorbidities, including diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, ventricular tachycardia/fibrillation and gastrointestinal bleeding ( p < 0.05). These subjects also likewise tended to present with higher serum levels of inflammatory markers, including D‐dimer, lactate dehydrogenase, high sensitivity troponin‐I and C‐reactive protein. Multivariate Cox regression showed that any type of cancer presented with an almost four‐fold increased risk of the primary outcome (HR: 3.77; 95% CI: 1.63–8.72; p < 0.002) after adjusting for significant demographics, Charlson comorbidity index, number of comorbidities, past comorbidities and medication history. This association remained significant when assessing those with colorectal (HR: 5.07; 95% CI: 1.50–17.17; p < 0.009) and gastrointestinal malignancies (HR: 3.79; 95% CI: 1.12–12.88; p < 0.03), but not with lung, genitourinary, or breast malignancies, relative to their respective cancer‐free COVID‐19 counterparts. Conclusions COVID‐19 cancer patients are associated with a significantly higher risk of intubation, ICU admission and/or mortality.

Clinical Characteristics and Outcomes in Hospitalized Patients with COVID-19 and Cancer History: A Multicenter Cross-Sectional Study in Southwestern Iran

“…The present study also showed that the prevalence of chronic respiratory diseases, except for asthma, was significantly higher in cancer patients with COVID-19, which is consistent with a number of previous studies 32 , 24 . On the contrary, some studies reported that there is no significant difference between cancer and non-cancer patients in terms of the prevalence of chronic respiratory diseases 9 , 10 , 12 .…”

“…In addition, the rates of ICU admission, intubation and death in cancer patients were significantly higher compared to non-cancer patients. These findings are in line with some previous studies 11 , 16 , 24 showing that cancer patients with COVID-19 were at higher risk for ICU admission, intubation, and death compared to people without malignancy. Patients with malignancy need more attention due to their sensitivity to infections and weak immune system, so under particular circumstances such as an epidemic of a viral disease, they definitely experience weaker outcomes compared to other patients.…”

“…Moreover, in the present study, blood disorders were significantly higher in cancer patients compared to non-cancer patients, which could be attributed to the underlying malignancy and mainly the side effects of anti-malignancy treatments. Consistent with the results of the present study, Zhou et al found that patients with cancer had significantly lower numbers of erythrocytes, platelets, and lymphocytes compared to non-cancer patients 24 . In Ruiz et al's study, 75.9% of cancer patients with COVID-19 had blood disorders including leukopenia, leukocytosis, and lymphopenia 21 .…”

“…In line with the results of the present study, the results of some previous studies also show that liver and kidney disorders are more common in cancer patients with COVID-19 compared to other patients. In Jiandong Zhou et al's study, for instance, there were significant differences between cancer and non-cancer patients in terms of liver and kidney function, with the former having a lower albumin and higher urea levels 24 . In Sorouri et al's study, the level of liver enzymes was significantly higher in cancer patients compared to the control group 11 .…”

Association between serum C-reactive protein (CRP) and Omicron variant COVID-19 pneumonia in cancer patients: A multicenter cross-sectional study at the end of 2022 in China

“…[12] However, few studies have assessed the role of CRP in cancer patients with COVID-19 infection. [13][14][15] Therefore, this cross-sectional study aims to assess the association between serum CRP levels and COVID-19 pneumonia in cancer patients infected with the Omicron variants from December 8, 2022 to February 1, 2023 in China.…”