Demography and Outcome of Cancer Patients with COVID-19: A Retrospective Cohort Study in Dharmais National Cancer Center Indonesia

Abstract

Introduction: Cancer patients have an increased risk of morbidity and mortality due COVID-19 partly due to their immunocompromised status. We aimed to investigate the associations of clinicopathological factors and survival outcomes in cancer patients with COVID-19. Methods: This was a retrospective cohort study comprised of cancer patients treated in Dharmais National Cancer Center, Indonesia. Main inclusion criteria were pathologically confirmed malignancy with positive results of RTPCR COVID-19 tests. Results: A total of 16,511 visitors had visited and registered for RTPCR test in Dharmais National Cancer Center from May 2020 to January 2021. Logistic regression showed that male gender (p-value = 0.019; OR = 1.732), haematological type of malignancy (p-value <0.001; OR = 3.073), patients not underwent cancer therapy (p-value = 0.008; OR = 0.485), low RTPCR Ct values (p-value = <0.001; OR = 3.340), poor performance status (p-value = <0.001; OR = 8,194), and disease severity (p-value = <0.001; OR = 5.448) were associated with mortality. Conclusion: Overall mortality rate in Dharmais cancer patients (25%) was higher than other cancer patients treated in other hospitals in Asia. Moreover, the mortality rate was similar across all age groups. Poor survival in young age might be explained by the fact that median age of cancer patients was 46 years old. In addition to male gender, cancer patients with low Ct values and having delayed cancer treatment were vulnerable groups of having poor outcomes when diagnosed with COVID-19. Long-term follow-up is required to examine the survival rate in cancer patients with COVID-19.