The Impact of COVID-19 Pandemic in Portuguese Cancer Patients: A Retrospective Study.

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.