Original Articles

Cancer has an independent association with death in hospitalized patients with COVID-19: a single-center study in Iran

Abstract

Background: COVID-19 could cause severe complications in those with pre-existing conditions such as cancer. Here, we aimed to assess the outcome of COVID-19 in hospitalized patients with a history of cancer. Methods: In this retrospective cohort study, we extracted patients' records with any cancer history out of hospitalized patients with COVID-19. Our patients were admitted between February 20th up to July 15th. The primary outcome was death, and the secondary outcomes were overall survival, COVID-19 specific mortality, admission to intensive care unit (ICU) and hospital stay. A group of individuals was selected out of the COVID-19 cohort without cancer history and matched for age, gender, and pre-existing conditions. We utilized univariate and multivariate logistic regression to analyze the association of studied variables and primary outcomes. Results: We identified 46 patients with cancer and COVID-19. The median age was 63, and 54.3% were male. According to the univariate logistic regression analysis, the death was 5.3 (CI95%: 1.75-15.85) times more probable in the cancer patients versus controls (p=0.003). The multivariate analysis adjusted for having cancer and sex, age, and having any comorbidity showed this figure was 5.5 (CI95%:1.8-16.8) (p=0.003). The 30- and 90-day COVID-19 specific mortality was 30% (CI95%:17-43) and 33% (CI95%: 20-46), respectively. Conclusion: Patients with COVID-19 who have a history of cancer have a considerably higher risk of death irrespective of age, gender, and other pre-existing conditions. A group of cancer patients needs the most vigorous care, those with advanced cancers and concurrent bacterial infections.
1. Addeo A, Friedlaender A. Cancer and COVID-19: Unmasking their ties [Internet]. Cancer Treat. Rev. W.B. Saunders Ltd; 2020. Available from: https://pubmed.ncbi.nlm.nih.gov/32516704/
2. Wu F, Zhao S, Yu B, Chen Y-M, Wang W, Song Z-G, et al. A new coronavirus associated with human respiratory disease in China. Nature. Springer Science and Business Media LLC; 2020;579:265–9.
3. Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, Abdel-Rahman O, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017: A systematic analysis for the global burden of disease study. JAMA Oncol [Internet]. American Medical Association; 2019;5:1749–68. Available from: https://pubmed.ncbi.nlm.nih.gov/31560378/
4. Barry A, Apisarnthanarax S, O’Kane GM, Sapisochin G, Beecroft R, Salem R, et al. Management of primary hepatic malignancies during the COVID-19 pandemic: recommendations for risk mitigation from a multidisciplinary perspective [Internet]. Lancet Gastroenterol. Hepatol. Elsevier Ltd; 2020. p. 765–75. Available from: http://www.thelancet.com/gastrohep
5. Wang H, Zhang L. Risk of COVID-19 for patients with cancer. Lancet Oncol [Internet]. Elsevier Ltd; 2020 [cited 2020 Mar 29];2019:S1470-2045(20)30149-2. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1470204520301492
6. Zendehdel K. Cancer Statistics in I.R. Iran in 2018. Basic Clin Cancer Res [Internet]. 2019 [cited 2020 Mar 26];11:1–4. Available from: www.bccrjournal.com
7. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China [Internet]. Lancet Oncol. 2020 [cited 2020 Mar 29]. p. 335–7. Available from: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30096-6/fulltext?utm_source=yxnews&utm_medium=desktop&utm_referrer=https%3A%2F%2Fyandex.com%2Fnews
8. He W, Chen L, Chen L, Yuan G, Fang Y, Chen W, et al. COVID-19 in persons with haematological cancers. Leukemia. 2020;34:1637–45.
9. Passaro A, Peters S, Mok TSK, Attili I, Mitsudomi T, de Marinis F. Testing for COVID-19 in lung cancer patients. Ann Oncol [Internet]. European Society for Medical Oncology; 2020;31:832–4. Available from: https://doi.org/10.1016/j.annonc.2020.04.002
10. Assaad S, Avrillon V, Fournier ML, Mastroianni B, Russias B, Swalduz A, et al. High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR. Eur J Cancer. 2020;135:251–9.
11. Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31:894–901.
12. Garassino MC, Whisenant JG, Huang LC, Trama A, Torri V, Agustoni F, et al. COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study. Lancet Oncol. 2020;21:914–22.
13. Lee LYW, Cazier JB, Starkey T, Turnbull CD, Kerr R, Middleton G. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet. 2020;395:1919–26.
14. Mehta V, Goel S, Kabarriti R, Cole D, Goldfinger M, Acuna-Villaorduna A, et al. Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discov. 2020;10:935–41.
Files
IssueVol 13 No 1 (2021) QRcode
SectionOriginal Articles
Keywords
Iran Cancer COVID-19 SARS-CoV-2 epidemic chemotherapy

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Ghaletaki R, Kolahdouzan K, Rezaei S, Bagheri F, Jafari F, Chavoshi M, Mohammadi N, Seyyedsalehi MS, Nahvijou A, Mousavi Darzikolaee N, Salarvand S, Kazemian A, Aghili M, Zendehdel K. Cancer has an independent association with death in hospitalized patients with COVID-19: a single-center study in Iran. Basic Clin Cancer Res. 2021;13(1):1-8.