Abstract
BackgroundAlthough research on the effects of comorbidities on coronavirus disease 2019 (COVID-19) patients is increasing, the risk of cancer history has not been evaluated for the mortality of patients with COVID-19.MethodsIn this retrospective study, we included 3232 patients with pathogen-confirmed COVID-19 who were hospitalized between January 18th and March 27th, 2020, at Tongji Hospital in Wuhan, China. Propensity score matching was used to minimize selection bias.ResultsIn total, 2665 patients with complete clinical outcomes were analyzed. The impacts of age, sex, and comorbidities were evaluated separately using binary logistic regression analysis. The results showed that age, sex, and cancer history are independent risk factors for mortality in hospitalized COVID-19 patients. COVID-19 patients with cancer exhibited a significant increase in mortality rate (29.4% vs. 10.2%, P < 0.0001). Furthermore, the clinical outcomes of patients with hematological malignancies were worse, with a mortality rate twice that of patients with solid tumors (50% vs. 26.1%). Importantly, cancer patients with complications had a significantly higher risk of poor outcomes. One hundred nine cancer patients were matched to noncancer controls in a 1:3 ratio by propensity score matching. After propensity score matching, the cancer patients still had a higher risk of mortality than the matched noncancer patients (odds ratio (OR) 2.98, 95% confidence interval (95% CI) 1.76–5.06). Additionally, elevations in ferritin, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, procalcitonin, prothrombin time, interleukin-2 (IL-2) receptor, and interleukin-6 (IL-6) were observed in cancer patients.ConclusionsWe evaluated prognostic factors with epidemiological analysis and highlighted a higher risk of mortality for cancer patients with COVID-19. Importantly, cancer history was the only independent risk factor for COVID-19 among common comorbidities, while other comorbidities may act through other factors. Moreover, several laboratory parameters were significantly different between cancer patients and matched noncancer patients, which may indicate specific immune and inflammatory reactions in COVID-19 patients with cancer.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) can cause the infectious respiratory illness known as coronavirus disease 2019 (COVID-19), which was first identified in December 2019 and has since spread globally [1,2,3]
We evaluated prognostic factors with epidemiological analysis and highlighted a higher risk of mortality for cancer patients with COVID-19
Cancer history was the only independent risk factor for COVID-19 among common comorbidities, while other comorbidities may act through other factors
Summary
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) can cause the infectious respiratory illness known as coronavirus disease 2019 (COVID-19), which was first identified in December 2019 and has since spread globally [1,2,3]. Research on the effects of comorbidities in COVID-19 patients is increasing, most related studies have reported the unadjusted risk of comorbidities with a relatively small sample size [7,8,9,10]. Several published works with relatively small sample sizes have reported the risk factors for mortality in patients with COVID-19 [7, 11,12,13]. Studies focusing on the association of cancer history with mortality in hospitalized patients with COVID-19 are rare. Research on the effects of comorbidities on coronavirus disease 2019 (COVID-19) patients is increasing, the risk of cancer history has not been evaluated for the mortality of patients with COVID-19
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