Abstract
AimIn a consecutive series of cancer patients tested for SARS-CoV-2 infection, this retrospective population-based study investigates the risks of viral infection and death.MethodsMalignancies were distinguished as incident or prevalent (active or inactive). Cancer management and vital status were retrieved from institutional regional databases. Comorbidities were recorded, based on Adjusted Clinical Groups (ACG). Six Resource Utilization Bands (RUBs) were also considered. Independent risk factors for SARS-CoV-2 infection and death were identified using multivariable logistic regression, considering sex, age, comorbidities and RUBs, cancer status (active versus prevalent), primary cancer site, and treatments (chemotherapy and/or radiotherapy).ResultsAmong 34,929 cancer patients, 1,090 (3.1%) tested positive for SARS-CoV-2 infection (CoV2+ve). The risk of infection was associated with age (OR per 1-year increase=1.012; 95%CI=1.007-1.017), prevalent-inactive disease, hematologic malignancies (OR=1.33; 95%CI=1.03-1.72) and RUB (OR per 1-level increase=1.14; 95%CI=1.05-1.24). Among CoV2+ve cancer patients, the risk of death was doubled for males, and increased with age (OR per 1-year increase=1.07; 95%CI=1.06-1.09) and comorbidities (renal [OR=3.18; 95%CI=1.58-6.49], hematological [OR=3.08; 95%CI=1.49-6.50], respiratory [OR=2.87; 95%CI=1.61-5.14], endocrine [OR=2.09; 95%CI=1.25-3.51]). Lung and blood malignancies raised the mortality risk (OR=3.55; 95%CI=1.56-8.33, and OR=1.81; 95%CI=1.01-3.25 respectively). Incident or prevalent-active disease and recent chemotherapy and radiotherapy (OR=4.34; 95%CI=1.85-10.50) increased the risk of death.ConclusionIn a large cohort of cancer patients, the risk of SARS-CoV-2 infection was higher for those with inactive disease than in incident or prevalent-active cases. Among CoV2+ve cancer patients, active malignancies and recent multimodal therapy both significantly raised the risk of death, which increased particularly for lung cancer.
Highlights
The epidemiology and clinical outcome of SARS-CoV-2 infection are both modulated by several biological and clinical variables including viral biology, ethnicity, sex susceptibility, and patients’ comorbidities (1–3).Cancer patients are considered prone to infectious diseases
While a number of valuable studies compared the risk of SARS-CoV-2 infection and its clinical outcomes in cancer versus non-cancer patients, few population studies focused on cancer patients with versus without the viral infection to address the factors influencing the risk of contracting the virus and the clinical course of the viral disease (8–12)
Primary endpoints of this study were to assess the risks of viral infection and death in a cohort of consecutive cancer patients tested for SARS-CoV-2, considering demographics, cancer-related variables, and comorbidities
Summary
Cancer patients are considered prone to (mainly opportunistic) infectious diseases This condition may be further promoted by several determinants, including immunocompetent status (primary and/or after anti-cancer therapies), time elapsing between the diagnosis of cancer and infection, and cancer biology, site and stage. Given this heterogeneous clinico-biological picture, the information available on the risk of SARS-CoV-2 infection and its clinical outcomes in cancer patients is still confusing (4–7). Primary endpoints of this study were to assess the risks of viral infection and death in a cohort of consecutive cancer patients tested for SARS-CoV-2, considering demographics (age and sex), cancer-related variables (site of the primary malignancy, prevalent versus incident cancers, anticancer therapies), and comorbidities (as recorded according to Adjusted Clinical Groups [ACG])
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
