Abstract
Literature reports that SARS-CoV-2 infection in cancer patients may be associated with higher severity and mortality, nevertheless the knowledge is limited. We aimed to describe patients’ demographic characteristics and COVID-19 disease outcomes in Portuguese cancer patients. We conducted a retrospective study in a cohort of cancer patients diagnosed with COVID-19. A total of 127 individuals were included: 46.5% males and 53.5% females, with a median age of 72 years. Clinicopathological characteristics were used in univariate and multivariable logistic regression analyses to estimate odds ratios for each variable with outcomes adjusting for potential confounders. Our cohort revealed that 84.3% of patients had more than one risk factor for severe disease rather than cancer. In total, 36.2% of patients were admitted to the Department of Internal Medicine, 14.2% developed severe disease, 1.6% required Intensive Care Unit, and mortality was observed in 11.8%. Severe COVID-19 disease was associated with unfit (ECOG PS > 2) patients (p = 0.009; OR = 6.39; 95% CI: 1.60–25.59), chronic kidney disease (p = 0.004; OR = 20.7; 95% CI: 2.64–162.8), immunosuppression (p < 0.001; OR = 10.3; 95% CI: 2.58–41.2), and presence of respiratory symptoms at diagnosis (p = 0.033; OR = 5.05; 95% CI: 1.14–22.4). Increased risk for mortality was associated with unfit patients (p = 0.036; OR = 4.22; 95% CI: 1.10–16.3), cardiac disease (p = 0.003; OR = 8.26; 95% CI: 2.03–33.6) and immunosuppression (p = 0.022; OR = 5.06; 95% CI: 1.27–20.18). Our results demonstrated that unfit and immunosuppressed patients, with chronic kidney disease and cardiac disease, have, respectively, an increased risk for severe disease and mortality related to COVID-19. Hence, this study provides important information on risk factors for severe COVID-19 disease and associated mortality in a Portuguese cancer population.
Highlights
A novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) has widely spread across the world since its first reported case in late December2019 in Wuhan, China [1]
This study retrospectively describes a cohort of cancer patients over 18 years old consecutively admitted to CHEDV during the year 2020 who tested positive for SARS-CoV2
A recently published meta-analysis revealed that age over 65 years and male gender were associated with severe events, defined as those requiring being admitted to the Intensive Care Unit (ICU), invasive ventilation, or associated death [12]. This was not observed in our study, and different reasons may explain it: (1) we considered the COVID-19 severity criteria as defined by the World Health Organization (WHO); (2) males and females were represented in our cohort; and (3) in our study patients were ~10 years older than the patients included in the meta-analysis (72 years vs. 63 years)
Summary
A novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) has widely spread across the world since its first reported case in late December. 2019 in Wuhan, China [1]. The World Health Organization (WHO) promptly declared the coronavirus disease of 2019 (COVID-19) a public health emergency of international concern [2]. Since March 2020, this virus has affected more than 150M individuals causing more than 3.2M deaths in 220 countries and territories [2].
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