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. 2023 Feb;109(1):38-46.
doi: 10.1177/03008916211073771. Epub 2022 Feb 8.

Outcomes of SARS-CoV-2 infection in cancer versus non-cancer-patients: a population-based study in northeastern Italy

Massimo Rugge  1   2 , Manuel Zorzi  2 , Stefano Guzzinati  2 , Carmen Stocco  2 , Francesco Avossa  3 , Stefania Del Zotto  4 , Elena Clagnan  4 , Ludovica Bricca  1 , Luigino Dal Maso  5 , Diego Serraino  5
Affiliations

Outcomes of SARS-CoV-2 infection in cancer versus non-cancer-patients: a population-based study in northeastern Italy

Massimo Rugge et al. Tumori. 2023 Feb.

Abstract

Introduction: This study assesses the risk of infection and clinical outcomes in a large consecutive population of cancer and non-cancer patients tested for SARS-CoV-2 status.

Methods: Study patients underwent SARS-CoV-2 molecular-testing between 22 February 2020 and 31 July 2020, and were found infected (CoV2+ve) or uninfected. History of malignancy was obtained from regional population-based cancer registries. Cancer-patients were distinguished by time between cancer diagnosis and SARS-CoV-2 testing (<12/⩾12 months). Comorbidities, hospitalization, and death at 15 September 2020 were retrieved from regional population-based databases. The impact of cancer history on SARS-CoV-2 infection and clinical outcomes was calculated by fitting a multivariable logistic regression model, adjusting for sex, age, and comorbidities.

Results: Among 552,362 individuals tested for SARS-CoV-2, 55,206 (10.0%) were cancer-patients and 22,564 (4.1%) tested CoV2+ve. Irrespective of time since cancer diagnosis, SARS-CoV-2 infection was significantly lower among cancer patients (1,787; 3.2%) than non-cancer individuals (20,777; 4.2% - Odds Ratio (OR)=0.60; 0.57-0.63). CoV2+ve cancer-patients were older than non-cancer individuals (median age: 77 versus 57 years; p<0.0001), were more frequently men and with comorbidities. Hospitalizations (39.9% versus 22.5%; OR=1.61; 1.44-1.80) and deaths (24.3% versus 9.7%; OR=1.51; 1.32-1.72) were more frequent in cancer-patients. CoV2+ve cancer-patients were at higher risk of death (lung OR=2.90; 1.58-5.24, blood OR=2.73; 1.88-3.93, breast OR=1.77; 1.32-2.35).

Conclusions: The risks of hospitalization and death are significantly higher in CoV2+ve individuals with past or present cancer (particularly malignancies of the lung, hematologic or breast) than in those with no history of cancer.

Keywords: Cancer Registry; Cancer outcome; Cancer prognosis; Covid 19 outcomes; SARS-CoV-2.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of the study population and of study outcomes.
See this image and copyright information in PMC

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