Clinical Profile and Outcomes of COVID-19 Patients with MalignancyA Cross-sectional Study

Abstract

Introduction: Patients with history of past or active malignancy are at increased risk of contracting the virus and developing Coronavirus Disease 2019 (COVID-19) related complications. With the global prevalence of cancer and the high transmissibility of Severe Acute Respiratory Syndrome Corona Virus 2 (SARSCoV-2), an understanding of the disease course of COVID-19 and factors influencing clinical outcomes in patients with cancer is necessary and is largely unknown. Aim: To study the laboratory characteristics of patients with malignancy and COVID-19 infection and to evaluate the outcomes in terms of clinical features, severity of infection and mortality of patients with malignancy and COVID-19 infection. Materials and Methods: The present study was a crosssectional study conducted at Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India after obtaining Institutional Ethical Committee (IEC) clearance, involving 72 subjects with COVID-19 infection. The duration of the study was from April-November 2020. Demographic details and data were collected in patients with active or previous malignancy and COVID-19 illness based on Indian Council of Medical Research (ICMR) criteria. Clinical outcome of the patients was measured based on need for Intensive Care Unit (ICU) admission, oxygen therapy and mortality. Descriptive statistics of the explanatory and outcome variables were calculated by mean, Standard Deviation (SD), median and Interquartile Range (IQR) for quantitative variables, frequency and proportions for qualitative variables. Inferential statistics like Chi-square test was applied for qualitative variables. Results: The mean age of the subjects was 52.10±14.512 years with 29 males, 43 females. Among 72 patients with malignancy, patients were classified as mild (23), moderate (22) and severe (27) according to ICMR case type respectively. Among the total patients, 21 (29.2%) were asymptomatic and 51 (70.8%) were symptomatic with 26 (36.1%) symptomatic patients having severe disease. Also, 30 (41.7%) had requirement of O2 and 28 (38.9%) were admitted to ICU. Most common was solid organ (66) lung carcinoma (13), breast (10), compared to haematological malignancies (6). A total of 22 (30.6%) patients had mortality with most common complication being Acute Respiratory Distress Syndrome (ARDS) (20.8%) followed by sepsis (4.2%). Conclusion: The results of present study revealed higher mortality and increased inflammatory markers in patients with severe COVID-19 infection and malignancy.