COVID-19 impact and predictive factors for mortality in cancer patients

ABSTRACT

Background: SARS-CoV-2 is a novel coronavirus that has been responsible for the largest pandemic in the last century COVID-19. This disease has widely affected Spain with a high lethality in ancient patients (pts) and with comorbidities. Oncological pts were not an exception. Methods: We evaluated the association between COVID-19 mortality and clinical/laboratory/radiological parameters in cancer pts from March to April 2020 at our institution. Past medical history and COVID-19-related parameters (symptoms, laboratory/x-ray findings and treatments) were retrospectively collected. Univariate analysis (UA) has been done using Fisher exact and U-Mann-Withney test for qualitative and quantitative variables, respectively. Multivariant analysis (MA) has been done using logistic regression. Results: Forty three hospitalized pts were diagnosed with COVID-19;30 pts (69.8%) were symptomatic on admission and 13 pts (30.2%) were hospital-acquired cases. Median age was 68.8 ± 7.8 years. Most part of the pts had gastrointestinal (GI) (13;30.2%), thoracic (Tx) (12;27.9%) and breast (6;14%) cancer. A higher prevalence of Tx tumours compared to our new pts prevalence is observed (9%). Fever was the most common symptom (27;62.8%) and bilateral pneumonia was observed in 24 pts (55.8%). SARS-Co-V-2 PCR was positive in 34 pts (79.1%). Hydroxychloroquine was administered in 35 pts (81.4%), steroids and antiretrovirals in 19 pts (44.1%) and tocilizumab in 12 pts (27.9%). Mortality rate due to COVID-19 was 30.23% (13 pts) and 8 pts could resume oncological treatment. Hypertension (HTA) and previous daily steroids given during last month before admission;as well as performance status, fever, Curb-65, SOFA score and D-Dimer (DD) at admission were associated with COVID-19 mortality in UA. Similarly, high flow oxygen requirements during hospitalization and DD at 72 hours are predictors of mortality. HTA [OR 8.3 (1-5-70.1)], steroids [OR 10.7 (1.3 – 143.8)] and fever [OR 0.09 (0.01 – 0.55)]were also associated in MA. Conclusions: COVID-19 showed a relative higher incidence in pts with Tx and GI tumours. Some clinical and laboratory parameters were found to be predictive factors for mortality as previously reported in non-cancer pts. Further investigations with larger number of pts are needed. Legal entity responsible for the study HM Hospitales. Funding: Has not received any funding. Disclosure All authors have declared no conflicts of interest.