Abstract
Background: The novel coronavirus infectious disease (COVID-19) is an international concern as it spreads through human populations and across national and international borders.Methods: In this retrospective study, we consecutively included all cancer patients who had been identified as having a nucleic acid-confirmed COVID-19 from two designated hospitals in Wuhan, China. COVID-19 patients without cancer were also enrolled for comparison. The clinical data were gathered from the medical records from Jan 14 to March 12, 2020.Results: Among the 117 cancer patients diagnosed with COVID-19, the median age was 63 years and 48.7% were male. Male sex, hematologic cancer, dyspnea on admission, and anti-cancer therapies were associated with an increased risk of mortality in cancer patients with COVID-19. We found that elevated levels of TNF-α, IL-2R, IL-6, and IL-8 were associated with a poorer prognosis in cancer patients with COVID-19, but no statistically significant association was found in patients without cancer. In addition, IL-2R and IL-6 markedly decreased in cancer patients who recovered from COVID-19. However, lymphocyte subsets were diminished in cancer patients who died from COVID-19, including total T cells, total B cells, helper T (Th) cells and suppressor T (Ts) cells.Conclusions: Cancer patients with COVID-19 were associated with high mortality (23.9%). A decrease in lymphocyte subsets and higher levels of cytokines were associated with a higher risk of severe outcome and could be utilized as the reference index to predict the survival outcome of cancer patients with COVID-19.
Highlights
In December 2019, several pneumonia cases of unknown aetiology were identified in Wuhan, China [1]
We found that elevated levels of TNF-α, IL-2R, IL-6, and IL-8 were associated with a poorer prognosis in cancer patients with COVID-19, but no statistically significant association was found in patients without cancer
Our study demonstrated that cancer patients had more prominent laboratory abnormalities than noncancer patients, accompanied with cancer patients seriously ill as compared to patients without a history of cancer [1, 10, 11]. 28 of the 117 cancer patients progressed to severe pneumonia as of March 30, 2020 and died during hospitalization
Summary
In December 2019, several pneumonia cases of unknown aetiology were identified in Wuhan, China [1]. Coronaviruses mainly cause respiratory tract infections, such as Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV) [2], which have resulted in more than 10000 cases in the past twenty years, with death rates of 37% for MERS-CoV and 10% for SARS-CoV [3, 4]. Methods: In this retrospective study, we consecutively included all cancer patients who had been identified as having a nucleic acid-confirmed COVID-19 from two designated hospitals in Wuhan, China. Hematologic cancer, dyspnea on admission, and anti-cancer therapies were associated with an increased risk of mortality in cancer patients with COVID-19. A decrease in lymphocyte subsets and higher levels of cytokines were associated with a higher risk of severe outcome and could be utilized as the reference index to predict the survival outcome of cancer patients with COVID-19
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