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. 2021 Aug 5;21(1):760.
doi: 10.1186/s12879-021-06495-9.

Clinical features and death risk factors in COVID-19 patients with cancer: a retrospective study

Yi Zhou #  1 , Qiao Yang #  2 , Jun Ye #  3 , Xiaocheng Wu  4 , Xianhua Hou  5 , Yimei Feng  6 , Bangyu Luo  1 , Jixi Li  1 , Guangrong Yang  1 , Lingchen Li  1 , Xiu Yang  1 , Bin Wang  7 , Songtao Zhao  8 , Li Li  9 , Qi Li  10 , Zhi Xu  11 , Hao Wu  12 , Jianguo Sun  13
Affiliations

Clinical features and death risk factors in COVID-19 patients with cancer: a retrospective study

Yi Zhou et al. BMC Infect Dis. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread around the world. This retrospective study aims to analyze the clinical features of COVID-19 patients with cancer and identify death outcome related risk factors.

Methods: From February 10th to April 15th, 2020, 103 COVID-19 patients with cancer were enrolled. Difference analyses were performed between severe and non-severe patients. A propensity score matching (PSM) analysis was performed, including 103 COVID-19 patients with cancer and 206 matched non-cancer COVID-19 patients. Next, we identified death related risk factors and developed a nomogram for predicting the probability.

Results: In 103 COVID-19 patients with cancer, the main cancer categories were breast cancer, lung cancer and bladder cancer. Compared to non-severe patients, severe patients had a higher median age, and a higher proportion of smokers, diabetes, heart disease and dyspnea. In addition, most of the laboratory results between two groups were significantly different. PSM analysis found that the proportion of dyspnea was much higher in COVID-19 patients with cancer. The severity incidence in two groups were similar, while a much higher mortality was found in COVID-19 patients with cancer compared to that in COVID-19 patients without cancer (11.7% vs. 4.4%, P = 0.028). Furthermore, we found that neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) were related to death outcome. And a nomogram based on the factors was developed.

Conclusion: In COVID-19 patients with cancer, the clinical features and laboratory results between severe group and non-severe group were significantly different. NLR and CRP were the risk factors that could predict death outcome.

Keywords: C-reactive protein; COVID-19; Cancer; Neutrophil-to-lymphocyte ratio; Nomogram.

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Conflict of interest statement

All the authors declared no potential conflicts of interest in this article.

Figures

Fig. 1
Fig. 1
Development and validation of a nomogram. a A nomogram for predicting the probability of death. The observed value of each variable could get a matching point according to the point scale. Use the total points of all variables to evaluate the probability of death. b ROC curves for the nomogram, NLR and CRP. c Calibration plot, d decision curve and e clinical impact curve for the nomogram. ROC, receiver operating characteristic; NLR, neutrophil-to-lymphocyte ratio; CRP, C-reactive protein
Fig. 2
Fig. 2
A chart of risk stratification by using neutrophil-to-lymphocyte ratio and C-reactive protein
See this image and copyright information in PMC

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