Clinical characteristics and outcomes of COVID-19 disease in patients with cancer
Journal of Clinical Oncology
; 40(16), 2022.
Article
in English
| EMBASE | ID: covidwho-2009606
ABSTRACT
Background:
The Coronavirus Disease 2019 (COVID-19) has been nominated as a pandemic by the World Health Organization short after has spreaded globally. Unfortunately, even after several effective vaccines approved by FDA, COVID-19 cases are still surging. Compared to the general population, patients with cancer are more susceptible to COVID-19 for many aspects. Therefore, better understanding of the clinical characteristics of cancer patients with COVID-19 is urgently needed to spare these vulnerable patients from severe disease course.Methods:
This retrospective study was completed in Capital Health Regional Medical Center, New jersey, USA. Adult patients with COVID-19 diagnosed between March 2020 and May 2021 were included in this study. All selected COVID-19 patients were stratified as two groups Patients with cancer and patients without cancer. Other variables were included as age at diagnosis, gender, race/ethnicity, insurance status, obesity, comorbidity score, treatment of COVID-19, oxygen requirement and vital status. The Charlson Comorbidity Index was used to calculate the comorbidity score.Results:
A total of 562 COVID-19 patients were included in this study;67 (12%) patients diagnosed with cancer. Patients with cancer were more likely to be older (73 vs. 62 years, p < 0.001), overweight (BMI 25-29.9) (39% vs 28%, p = 0.02), and have higher comorbidity score > 3 (58% vs 15%, p < 0.001) than patients without cancer. Patients with cancer more frequently received steroid therapies (52% vs. 34%, p = 0.003), remdesivir (21% vs. 4%, p < 0.001), and convalescent plasma (21% vs. 10%, p = 0.009). The rate of high flow oxygen therapy was higher in patients with cancer than patients without cancer (30% vs. 16%, p = 0.02). The days of mechanic ventilation, hospital stay, ICU admission were similar between two groups. Patients without cancer had better survival rate compared to patients with cancer (77% vs. 64%, p = 0.02). Patients with cancer had increased D-dimer level (2.4 vs. 1.6 mg/L, p = 0.08) compared to patients without cancer but it was not significantly different. Other laboratory findings were also similar between two groups, including WBC, neutrophils, lymphocytes, lactate, lactate dehydrogenase, creatine kinase, d-dimer, C-reactive protein, procalcitonin, fibrinogen, BNP, troponin, sodium, AST, ALT, and ferritin. Multivariable logistic regression analysis showed that patients with cancer were associated with increased odds of higher than 3 comorbidity score (OR 7.09 [3.85-13.05], p < 0.001) and oxygen therapy with nasal cannula up to 6 liters (OR 3.7 [1.04-13.5], p = 0.04).Conclusions:
This present analysis showed that patients had increased risk of mortality compared to counterpart. Our results emphasize that cancer patients as a group are at higher risk due to advanced age and preexisting conditions.
C reactive protein; convalescent plasma; creatine kinase; D dimer; endogenous compound; ferritin; fibrinogen; lactate dehydrogenase; lactic acid; oxygen; procalcitonin; remdesivir; sodium; troponin; adult; advanced cancer; artificial ventilation; aspartate aminotransferase level; body mass; cancer patient; cancer survival; Charlson Comorbidity Index; clinical feature; conference abstract; controlled study; coronavirus disease 2019; drug therapy; ethnicity; female; gender; high flow nasal cannula therapy; hospitalization; human; human cell; insurance; lymphocyte; major clinical study; male; mortality risk; nasal cannula; neutrophil; New Jersey; obesity; outcome assessment; oxygen therapy; race; retrospective study; risk assessment; steroid therapy; survival rate
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Journal of Clinical Oncology
Year:
2022
Document Type:
Article
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