TY - JOUR
T1 - Clinical characteristics, risk factors and outcomes of cancer patients with COVID-19
T2 - A population-based study
AU - Zhou, Jiandong
AU - Lakhani, Ishan
AU - Chou, Oscar
AU - Leung, Keith Sai Kit
AU - Lee, Teddy Tai Loy
AU - Wong, Michelle Vangi
AU - Li, Zhen
AU - Wai, Abraham Ka Chung
AU - Chang, Carlin
AU - Wong, Ian Chi Kei
AU - Zhang, Qingpeng
AU - Tse, Gary
AU - Cheung, Bernard Man Yung
N1 - Publisher Copyright:
© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
PY - 2023/1
Y1 - 2023/1
N2 - Introduction: Cancer patients may be susceptible to poorer outcomes in COVID-19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions. Methods: This was a population-based retrospective cohort study of COVID-19 patients who presented to Hong Kong public hospitals between 1 January 2020 and 8 December 2020. The primary outcome was a composite endpoint of requirement for intubation, ICU admission and 30-day mortality. Results: The following study consisted of 6089 COVID-19 patients (median age 45.9 [27.8.1–62.7] years; 50% male), of which 142 were cancer subjects. COVID-19 cancer patients were older at baseline and tended to present with a higher frequency of comorbidities, including diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, ventricular tachycardia/fibrillation and gastrointestinal bleeding (p < 0.05). These subjects also likewise tended to present with higher serum levels of inflammatory markers, including D-dimer, lactate dehydrogenase, high sensitivity troponin-I and C-reactive protein. Multivariate Cox regression showed that any type of cancer presented with an almost four-fold increased risk of the primary outcome (HR: 3.77; 95% CI: 1.63–8.72; p < 0.002) after adjusting for significant demographics, Charlson comorbidity index, number of comorbidities, past comorbidities and medication history. This association remained significant when assessing those with colorectal (HR: 5.07; 95% CI: 1.50–17.17; p < 0.009) and gastrointestinal malignancies (HR: 3.79; 95% CI: 1.12–12.88; p < 0.03), but not with lung, genitourinary, or breast malignancies, relative to their respective cancer-free COVID-19 counterparts. Conclusions: COVID-19 cancer patients are associated with a significantly higher risk of intubation, ICU admission and/or mortality.
AB - Introduction: Cancer patients may be susceptible to poorer outcomes in COVID-19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions. Methods: This was a population-based retrospective cohort study of COVID-19 patients who presented to Hong Kong public hospitals between 1 January 2020 and 8 December 2020. The primary outcome was a composite endpoint of requirement for intubation, ICU admission and 30-day mortality. Results: The following study consisted of 6089 COVID-19 patients (median age 45.9 [27.8.1–62.7] years; 50% male), of which 142 were cancer subjects. COVID-19 cancer patients were older at baseline and tended to present with a higher frequency of comorbidities, including diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, ventricular tachycardia/fibrillation and gastrointestinal bleeding (p < 0.05). These subjects also likewise tended to present with higher serum levels of inflammatory markers, including D-dimer, lactate dehydrogenase, high sensitivity troponin-I and C-reactive protein. Multivariate Cox regression showed that any type of cancer presented with an almost four-fold increased risk of the primary outcome (HR: 3.77; 95% CI: 1.63–8.72; p < 0.002) after adjusting for significant demographics, Charlson comorbidity index, number of comorbidities, past comorbidities and medication history. This association remained significant when assessing those with colorectal (HR: 5.07; 95% CI: 1.50–17.17; p < 0.009) and gastrointestinal malignancies (HR: 3.79; 95% CI: 1.12–12.88; p < 0.03), but not with lung, genitourinary, or breast malignancies, relative to their respective cancer-free COVID-19 counterparts. Conclusions: COVID-19 cancer patients are associated with a significantly higher risk of intubation, ICU admission and/or mortality.
KW - COVID-19
KW - cancer
KW - intensive care unit
KW - intubation
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=85131016004&partnerID=8YFLogxK
U2 - 10.1002/cam4.4888
DO - 10.1002/cam4.4888
M3 - Article
C2 - 35642123
AN - SCOPUS:85131016004
VL - 12
SP - 287
EP - 296
JO - Cancer Medicine
JF - Cancer Medicine
IS - 1
ER -
