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. 2020 Jun 10;13(1):75.
doi: 10.1186/s13045-020-00907-0.

Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis

Yifan Meng  1   2 , Wanrong Lu  1   2 , Ensong Guo  1   2 , Jia Liu  1   2 , Bin Yang  1   2 , Ping Wu  1   2 , Shitong Lin  1   2 , Ting Peng  1   2 , Yu Fu  1   2 , Fuxia Li  1   2 , Zizhuo Wang  1   2 , Yuan Li  1   2 , Rourou Xiao  1   2 , Chen Liu  1   2 , Yuhan Huang  1   2 , Funian Lu  1   2 , Xue Wu  1   2 , Lixin You  1   2 , Ding Ma  3   4 , Chaoyang Sun  5   6 , Peng Wu  7   8 , Gang Chen  9   10
Affiliations

Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis

Yifan Meng et al. J Hematol Oncol. .

Abstract

Background: Although research on the effects of comorbidities on coronavirus disease 2019 (COVID-19) patients is increasing, the risk of cancer history has not been evaluated for the mortality of patients with COVID-19.

Methods: In this retrospective study, we included 3232 patients with pathogen-confirmed COVID-19 who were hospitalized between January 18th and March 27th, 2020, at Tongji Hospital in Wuhan, China. Propensity score matching was used to minimize selection bias.

Results: In total, 2665 patients with complete clinical outcomes were analyzed. The impacts of age, sex, and comorbidities were evaluated separately using binary logistic regression analysis. The results showed that age, sex, and cancer history are independent risk factors for mortality in hospitalized COVID-19 patients. COVID-19 patients with cancer exhibited a significant increase in mortality rate (29.4% vs. 10.2%, P < 0.0001). Furthermore, the clinical outcomes of patients with hematological malignancies were worse, with a mortality rate twice that of patients with solid tumors (50% vs. 26.1%). Importantly, cancer patients with complications had a significantly higher risk of poor outcomes. One hundred nine cancer patients were matched to noncancer controls in a 1:3 ratio by propensity score matching. After propensity score matching, the cancer patients still had a higher risk of mortality than the matched noncancer patients (odds ratio (OR) 2.98, 95% confidence interval (95% CI) 1.76-5.06). Additionally, elevations in ferritin, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, procalcitonin, prothrombin time, interleukin-2 (IL-2) receptor, and interleukin-6 (IL-6) were observed in cancer patients.

Conclusions: We evaluated prognostic factors with epidemiological analysis and highlighted a higher risk of mortality for cancer patients with COVID-19. Importantly, cancer history was the only independent risk factor for COVID-19 among common comorbidities, while other comorbidities may act through other factors. Moreover, several laboratory parameters were significantly different between cancer patients and matched noncancer patients, which may indicate specific immune and inflammatory reactions in COVID-19 patients with cancer.

Keywords: COVID-19; Cancer history, Independent risk factor; Comorbidities; Mortality; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have competing interests.

Figures

Fig. 1
Fig. 1
Flowchart for the inclusion of patients
Fig. 2
Fig. 2
Kaplan-Meier estimates of the proportion of patients with COVID-19. a The length of hospital stay for discharged patients according to cancer patients and matched noncancer controls; b the time from admission to death for patients who died according to cancer patients and matched noncancer controls
See this image and copyright information in PMC

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