COVID-19 Presentation and Outcomes among Cancer Patients: A Matched Case-Control Study

Abstract

It has been suggested that cancer patients are at higher risk of contracting COVID-19 and at higher risk of developing a severe form of the disease and fatality. This study’s objectives were to measure the excess risk of mortality and morbidity of patients with cancer among patients hospitalized for a SARS-CoV-2 infection, and to identify factors associated with the risk of death and morbidity among cancer patients. All first cancer patients hospitalized for COVID-19 in the two main hospitals of the Lyon area were included. These patients were matched based on age, gender, and comorbidities with non-cancer control patients. A total of 108 cancer patients and 193 control patients were included. The severity at admission and the symptoms were similar between the two groups. The risk of early death was higher among cancer patients, while the risk of intubation, number of days with oxygen, length of stay in ICU, and length of hospital stay were reduced. The main factors associated with early death among cancer patients was the severity of COVID-19 and the number of previous chemotherapy lines. The outcomes appear to be driven by the severity of the infection and therapeutic limitations decided at admission.

Impact of the First Wave of the COVID-19 Pandemic on the Lyon University Hospital Cancer Institute (IC-HCL)

“…Regarding the link between COVID-19 and the mortality of cancer patients, the results of the present small study are in concordance with the current understanding that adverse COVID-19 outcomes are principally driven by advanced stage, age, and the presence of other non-cancer comorbidities and that the risk to develop severe or critical symptoms of COVID-19 is correlated with factors co-occurring in cancer patients and not to the cancer condition per se [22][23][24][25][26]. The results of the present study also correlate with the findings that lung cancer seems to be an important risk factor for COVID-19 severity, certainly due to factors related to underlying pulmonary condition, as well as lower acceptance rate in critical care [27,28].…”

Effects of SARS-CoV-2 infections in patients with cancer on mortality, ICU admission and incidence: a systematic review with meta-analysis involving 709,908 participants and 31,732 cancer patients

“…A total of 42 studies (Akhtar et al 2021 ; Alpert et al 2021 ; Arslan et al 2021 ; Azarkar et al 2021 ; Baker et al 2021 ; Benelli et al 2020 ; Bennett et al 2021 ; Bernard et al 2021 ; Bhargava et al 2021 ; Borobia et al 2020 ; Pinto et al 2020 ; Chai et al 2021 ; Fu et al 2021 ; Gude-Sampedro et al 2021 ; Guo et al 2021 ; Joharatnam-Hogan et al 2020 ; Katkat et al 2021 ; Kim et al 2021 ; Kokturk et al 2021 ; Liang et al 2021 ; Sun et al 2021 ; Lunski et al 2021 ; Martinot et al 2021 ; Mirgh et al 2021 ; Miyashita et al 2020 ; Péron et al 2021 ; Poli et al 2022 ; Li et al 2020a , b ; Reddy et al 2021 ; Ricoca Peixoto et al 2020 ; Giorgi-Rossi et al 2020; Rugge et al 2020 ; Erdal et al 2021 ; Pérez-Segura et al 2021 ; Serraino et al 2021 ; Shahidsales et al 2021 ; Sorouri et al 2020 ; Stroppa et al 2020 ; Vergara et al 2021 ; Vila-Corcoles et al 2021 ; Zhang et al 2021 ; Zhou et al 2021 ) were included in the analysis to compare the mortality rates of cancer and non-cancer patients infected with SARS-CoV-2. There were a total of 557,053 participants, of whom 21,599 were cancer patients.…”

“…After a preliminary review and the elimination of duplicates, 5328 papers were screened and chosen for further evaluation. A total of 58 studies (Adejumo et al 2021 ; Akhtar et al 2021 ; Alpert et al 2021 ; Arslan et al 2021 ; Azarkar et al 2021 ; Baker et al 2021 ; Benelli et al 2020 ; Bennett et al 2021 ; Bergman et al 2021 ; Bernard et al 2021 ; Bhargava et al 2021 ; Borobia et al 2020 ; Pinto et al 2020 ; Chai et al 2021 ; Fu et al 2021 ; Chudasama et al 2021 ; Costa et al 2021 ; Duanmu et al 2020 ; Gold et al 2020 ; Görgülü et al 2020 ; Goyal et al 2020 ; Gude-Sampedro et al 2021 ; Guo et al 2021 ; Joharatnam-Hogan et al 2020 ; Katkat et al 2021 ; Kim et al 2021 ; Kokturk et al 2021 ; Liang et al 2021 ; Sun et al 2021 ; Cavanna et al 2020 ; Lunski et al 2021 ; Martinot et al 2021 ; Mirgh et al 2021 ; Miyashita et al 2020 ; Nakamura et al 2021 ; Nikpouraghdam et al 2020 ; Panda et al 2022 ; Péron et al 2021 ; Poli et al 2022 ; Li et al 2020a , b ; Reddy et al 2021 ; Regina et al 2020 ; Ricoca-Peixoto et al 2020 ; Giorgi-Rossi et al 2020 ; Rugge et al 2020 ; Erdal et al 2021 ; Sami et al 2020 ; Santorelli et al 2021 ; Pérez-Segura et al 2021 ; Serraino et al 2021 ; Shahidsales et al 2021 ; Sorouri et al 2020 ; Stroppa et al 2020 ; Tehrani et al 2021 ; Vergara et al 2021 ; Vila-Corcoles et al 20...…”

“…ICU admission rates of a total of 22,671 SARS-CoV-2 infected cancer patients and 532,161 non-cancer patients were analyzed from 22 eligible studies (Alpert et al 2021 ; Benelli et al 2020 ; Bergman et al 2021 ; Bernard et al 2021 ; Pinto et al 2020 ; Fu et al 2021 ; Costa et al 2021 ; Görgülü et al 2020 ; Gude-Sampedro et al 2021 ; Guo et al 2021 ; Joharatnam-Hogan et al 2020 ; Sun et al 2021 ; Lunski et al 2021 ; Martinot et al 2021 ; Mirgh et al 2021 ; Miyashita et al 2020 ; Péron et al 2021 ; Li et al 2020a , b ; Ricoca Peixoto et al 2020 ; Rugge et al 2020 ; Shahidsales et al 2021 ; Sorouri et al 2020 ). The rate of ICU admission in patients with cancer was significantly higher than in individuals without cancer (RR = 1.45, 95% CI: 1.28–1.64, p < 0.001; heterogeneity: df = 21, I 2 = 87%, p < 0.001) (Fig.…”

Experiences of cancer care in COVID-19: A longitudinal qualitative study

“…Over the course of the pandemic, our understanding of the impact of COVID-19 on cancer is increasing. COVID-19 infection in cancer patients puts them at risk of serious illness and early mortality ( Assaad et al, 2021 ; Fu et al, 2021 ; Miyashita et a., 2020 ; Nath et al, 2022 ; Robilotti et al, 2020 ; Taghizadeh-Hesary et al, 2021 ), especially those with haematological malignancies and lung cancer ( de Joode et al, 2022 ) and those with respiratory, endocrine and renal co-morbidities ( Al Bahrani et al, 2021 ; Zori et al, 2021 ), Moreover, the severity of COVID-19 infection and previous exposure to ≥3 lines of chemotherapy are other main factors associated with earlier death ( Péron et al, 2021 ). There is also clear evidence, that cancer diagnoses were delayed ( Dinmohamed et al, 2020 ), a trend expected to continue in the short term ( Alkatout et al, 2021 ).…”