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. 2023 Jan;12(1):287-296.
doi: 10.1002/cam4.4888. Epub 2022 May 31.

Clinical characteristics, risk factors and outcomes of cancer patients with COVID-19: A population-based study

Jiandong Zhou  1 , Ishan Lakhani  2 , Oscar Chou  3 , Keith Sai Kit Leung  4 , Teddy Tai Loy Lee  5 , Michelle Vangi Wong  2 , Zhen Li  6 , Abraham Ka Chung Wai  5 , Carlin Chang  7 , Ian Chi Kei Wong  8   9 , Qingpeng Zhang  1 , Gary Tse  2   10   11 , Bernard Man Yung Cheung  12
Affiliations

Clinical characteristics, risk factors and outcomes of cancer patients with COVID-19: A population-based study

Jiandong Zhou et al. Cancer Med. 2023 Jan.

Abstract

Introduction: Cancer patients may be susceptible to poorer outcomes in COVID-19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions.

Methods: This was a population-based retrospective cohort study of COVID-19 patients who presented to Hong Kong public hospitals between 1 January 2020 and 8 December 2020. The primary outcome was a composite endpoint of requirement for intubation, ICU admission and 30-day mortality.

Results: The following study consisted of 6089 COVID-19 patients (median age 45.9 [27.8.1-62.7] years; 50% male), of which 142 were cancer subjects. COVID-19 cancer patients were older at baseline and tended to present with a higher frequency of comorbidities, including diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, ventricular tachycardia/fibrillation and gastrointestinal bleeding (p < 0.05). These subjects also likewise tended to present with higher serum levels of inflammatory markers, including D-dimer, lactate dehydrogenase, high sensitivity troponin-I and C-reactive protein. Multivariate Cox regression showed that any type of cancer presented with an almost four-fold increased risk of the primary outcome (HR: 3.77; 95% CI: 1.63-8.72; p < 0.002) after adjusting for significant demographics, Charlson comorbidity index, number of comorbidities, past comorbidities and medication history. This association remained significant when assessing those with colorectal (HR: 5.07; 95% CI: 1.50-17.17; p < 0.009) and gastrointestinal malignancies (HR: 3.79; 95% CI: 1.12-12.88; p < 0.03), but not with lung, genitourinary, or breast malignancies, relative to their respective cancer-free COVID-19 counterparts.

Conclusions: COVID-19 cancer patients are associated with a significantly higher risk of intubation, ICU admission and/or mortality.

Keywords: COVID-19; cancer; intensive care unit; intubation; mortality.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Boxplot of Charlson's comorbidity index for hospitalized COVID‐19 cancer patients who developed the primary outcome.
FIGURE 2
FIGURE 2
Kaplan–Meier survival curves and cumulative hazards stratified by cancer presentation for severe composite outcome in hospitalized COVID‐19 patients.
See this image and copyright information in PMC

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