The impact of age, gender and active cancer in the mortality and the length of in-patient stay of patients with covid-19 at a uk district general hospital

ABSTRACT

RATIONALE An age-related mortality risk has been discovered during the COVID-19 pandemic;the elderly being at greater risk. This could be explained by age-related impairment of immunity. Social factors such as congregate housing could also play a role[1]. Similarly, cancer patients have been identified as being high-risk for mortality. Thromboembolic events arising as a result of a cytokine storm has been theorised as a potential cause of death as illustrated in figure 1[2]. Previous studies have highlighted male sex as being another high-risk group for morbidity and mortality[2] . We aim to investigate the effects of age, gender and active cancer on the mortality rate and the length of in-patient stay in patients with COVID-19. Methods: A retrospective study of all in-patients aged ≥ 18 years with a confirmed diagnosis of COVID-19 during the first wave of the pandemic. Statistical analysis was performed using the chi squared and Mann-Whitney U test. Results: 445 COVID-19 positive patients were included in the study, of which 69 had active cancer, 329 were aged <65 years and 116 were aged > 65 years. The study contained 261 males and 263 females. Mortality in patients with active cancer was higher (70%) compared to those without active cancer (48%) (P=0.001). There was no significant difference in the number of patients who had an inpatient stay of >7 days between both groups. We also found that there was a higher mortality rate in patients aged > 65 years (61%) compared to those aged < 65 years (25%) (P<0.05), with a greater number of patients aged > 65 years staying >7 days in-hospital (63%) compared to those aged < 65 years (49%) (P=0.03). There were no significant differences in the mortality rates and the length of in-patient stays of >7 days between male and female patients. However, interestingly males had a greater intubation rate (14%) compared to females (6%) (P=0.025). Conclusion: Our study demonstrated increasing age and active cancer status to be linked to greater risk of mortality. Furthermore, males showed a more severe disease course as compared to females. This data should be considered when highlighting at risk groups and prioritising them for treatment and isolation. Figure 1-A potential mechanism of death in COVID-19 patients References 1. Kang SJ et al Age-related Morbidity and Mortality among patients with COVID-19. Infect Chemother 2020;52(2)154-164 2. Curigliano G et al Cancer Patients and Risk of Mortality for COVID-19. Cancel Cell 2020;38(2)161-163.