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. 2021 Apr 24;12(12):3558-3565.
doi: 10.7150/jca.54205. eCollection 2021.

Severity of COVID-19 in Cancer patients versus patients without Cancer: A Propensity Score Matching Analysis

Chao Liu  1   2 , Kai Wang  3 , Luyuan Li  4 , Qingquan Lv  5 , Yumei Liu  6 , Tian Hu  6 , Jonathan C Trent  4 , Bing Sun  7 , Qinyong Hu  1
Affiliations

Severity of COVID-19 in Cancer patients versus patients without Cancer: A Propensity Score Matching Analysis

Chao Liu et al. J Cancer. .

Abstract

Purpose: Data are extremely limited with regards to the impact of COVID-19 on cancer patients. Our study explored the distinct clinical features of COVID-19 patients with cancer. Experimental Design: 189 COVID-19 patients, including 16 cancer patients and 173 patients without cancer, were recruited. Propensity score 1:4 matching (PSM) was performed between cancer patients and patients without cancer based on age, gender and comorbidities. Survival was calculated by the Kaplan-Meier method and the difference was compared by the log-rank test. Results: PSM analysis yielded 16 cancer patients and 64 propensity score-matched patients without cancer. Compared to patients without cancer, cancer patients tended to have leukopenia and elevated high-sensitivity C-reactive protein (hs-CRP) and procalcitonin. For those with critical COVID-19, cancer patients had an inferior survival than those without cancer. Also, cancer patients with severe/critical COVID-19 tended to be male and present with low SPO2 and albumin, and high hs-CRP, lactate dehydrogenase and blood urea nitrogen on admission compared to those with mild COVID-19. In terms of risk factors, recent cancer diagnosis (within 1 year of onset of COVID-19) and anti-tumor treatment within 3 months of COVID-19 diagnosis were associated with inferior survival. Conclusions: We found COVID-19 patients with cancer have distinct clinical features as compared to patients without cancer. Importantly, cancer patients with critical COVID-19 were found to have poorer outcomes compared to those without cancer. In the cancer cohort, patients with severe/critical COVID-19 presented with a distinct clinical profile from those with mild COVID-19; short cancer history and recent anti-cancer treatment were associated with inferior survival.

Keywords: COVID-19; cancer; clinical characteristics; propensity score matching; survival.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Comparisons of survival, fatality ratio and disease duration between COVID-19 CP and PWC (A); critical COVID-19 CP and PWC (B). CP, cancer patients; PWC, patients without cancer.
Figure 2
Figure 2
Survival analysis of mild and severe/critical COVID-19 CP (A); PWC (B); comparison of disease duration (C). CP, cancer patients; PWC, patients without cancer.
Figure 3
Figure 3
Comparisons of survival and fatality ratio between patients with cancer history > 1 year and ≤ 1 year (A) or anti-cancer therapy > 3 months and ≤ 3 months (B). ** represents p < 0.01.
See this image and copyright information in PMC

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