Risk Factors for In-Hospital Mortality among Cancer Patients with COVID-19: A Cross-Sectional Study

Abstract

Background: COVID-19 has been a major concern for people and healthcare systems since its emergence in China in December 2019. Patients with medical diseases are at a higher risk of severe disease development and mortality. Cancer patients are more vulnerable to infections. Several studies demonstrated that COVID-19 is associated with a greater risk of morbidity and mortality among cancer patients. However, the risk factors for mortality among these patients are still unknown. Objective: This study aimed to identify the risk factors associated with in-hospital death among cancer patients with COVID-19. Method: In this cross-sectional study, we analyzed demographic data, clinical characteristics and laboratory parameters of cancer patients with COVID-19 who were hospitalized in three tertiary referral hospitals in Tehran, Iran from February to May 2020. Diagnosis of COVID-19 was confirmed using real-time polymerase chain reaction testing and computed tomography scan findings. Data analysis was performed using SPSS software, version 20. P-value less than 0.05 was considered significant. Results: Sixty-six cancer patients with COVID-19 were enrolled in this study. Among participants, 35 (53.03%) patients were discharged, and 31 (46.97%) patients died in the hospital. Thirty-two (48.4%) patients suffered from hematologic and 34 (51.6%) from non-hematologic cancers. The most common comorbidities were hypertension (68.18%) and diabetes (56.06%). The most common symptoms among patients were rhinorrhea (59.1%), fever (54.5%), and dyspnea (48.4%), respectively. Diabetes (p= 0.00), hypoxemia (p= 0.005), and receiving chemotherapy or radiotherapy during the last three months (p= 0.022) were associated with a significantly greater risk of in-hospital mortality. Conclusion: Hypoxemia, diabetes, and the time interval between chemotherapy/radiotherapy and hospitalization are associated with a higher risk of in-hospital mortality among cancer patients with COVID-19. These risk factors should be considered in the clinical management of hospitalized COVID19 patients who suffer from cancers. In-hospital mortality and poor outcomes can be minimized by addressing risk factors.