Hospital and post-discharge mortality in COVID-19 patients with a preexisting cancer diagnosis in Iran (preprint)

ABSTRACT

Background: Data on COVID-19 outcomes in cancer patients from low- and middle-income countries is limited. We conducted a large study about the mortality rate of COVID-19 in cancer patients in Iran. Methods: We obtained clinical characteristics and outcomes of COVID-19 in cancer and non-cancer patients. Based on logistic regression models, the odds ratios (ORs) and 95% confidence intervals (CIs) for hospital death and 60-day mortality of cancer patients were estimated. Results: The cancer patients had higher ICU admission (35.8% vs. 26.6%) and intubation (25.4 vs. 11.6%) than non-cancer patients. Hospital mortality was higher in cancer patients (37.2%) than in non-cancer patients (15.2%) (OR = 4.56, 95% CI 3.51-5.93). Among cancer patients, mortality rates of the lung (OR = 1.57) and colorectal (OR = 1.50) cancers were higher than other cancer patients, albeit these associations were not statistically significant. The risk of 60-day mortality was significantly higher in lung cancer (OR = 1.75, 95% CI 1.04-2.93). The risk of COVID-19 death was higher in cancer patients who had an oxygen saturation less than 85% (OR = 1.79, 95% CI 1.20 -2.69), were on active treatment (OR = 1.94, 95% CI 1.43-2.6), or had metastasis (OR = 3.32, 95% 2.30-4.79) during the COVID-19 infection. Conclusion: COVID-19 mortality was higher in cancer patients, especially with active disease and metastatic. Among others, lung cancer patients experience the worst prognosis from COVID-19 infection. The excess risk of death after discharge from the hospital suggests providing follow-up care for cancer patients after discharge from a COVID-19 hospitalization.