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. 2023 Oct 12;53(6):1744-1755.
doi: 10.55730/1300-0144.5744. eCollection 2023.

COVID-19 in cancer patients: patient characteristics and outcomes in the post-COVID-19 vaccination period

Gülşen Iskender  1 , Duygu Mert  1 , Göknur Yapar Toros  2 , Funda Yilmaz  3 , Ersin Bozan  4 , Semra Tunçbilek  1 , Ömür Berna Çakmak Öksüzoğlu  5 , Fevzi Altuntaş  6 , Mustafa Ertek  1
Affiliations

COVID-19 in cancer patients: patient characteristics and outcomes in the post-COVID-19 vaccination period

Gülşen Iskender et al. Turk J Med Sci. .

Abstract

Background/aim: It wasaimed herein to investigate coronavirus disease (COVID-19) in cancer patients and compare hematological and solid organ cancer patients in terms of the course and outcome of this disease.

Materials and methods: Data from cancer patients with laboratory-confirmed COVID-19 infection were analyzed retrospectively. Risk factors for poor prognosis and the effect of vaccination on the clinical outcomes of the patients were evaluated.

Results: A total of 403 cancer patients who were diagnosed with COVID-19 between March 1st, 2021, and November 30th, 2022, were included, of whom 329 (81.6%) had solid and 74 (18.4%) had hematological cancers. Hospitalization and intensive care unit (ICU) admission rates were significantly higher in the hematological cancer patients compared to the solid organ cancer patients (73.0% vs. 35.9%, p< 0.001 and 25.7% vs. 14.0%, p= 0.013, respectively). The COVID-19-related case fatality rate (CFR) was defined as 15.4%, and it was higher in the hematologicalcancer patientsthan inthe solid organ cancer patients (23.0% vs. 13.7%, p= 0.045) and was higher in patients with metastatic/advanced disease compared to the other cancer stages (p< 0.001). In the solid organ cancergroup, hospitalization, ICU admission, and the COVID-19 CFR were higher in patients with respiratory and genitourinary cancers (p< 0.001). A total of 288 (71.8%) patients had receivedCOVID-19 vaccination; 164 (56.94%) had≤2 doses and 124 (43.06%) had≥3 doses. The hospitalization rate was higher in patients with ≤2 doses of vaccine compared to those with ≥3 doses (48.2% vs. 29.8%,p= 0.002). Patients with COVID-19-related death had higher levels of leucocyte, neutrophil, D-dimer, troponin, C-reactive protein (CRP), procalcitonin, and ferritin and lower levels of lymphocyte than the survivors. In the logistic regression analysis,the risk of COVID-19-related mortality was higher in the hematological cancer patients(OR:1.726), those who were male (OR:1.757), and with the Pre-Delta/Delta variants (OR:1.817).

Conclusion: This study revealed that there is an increased risk of COVID-19-related serious events (hospitalization, ICU admission, or death) in patients with hematological cancerscompared with those who have solid organ cancers. It wasalso shown that receiving ≥3 doses of COVID-19 vaccine is more protective against severe illness and the need for hospitalization than ≤2 doses.

Keywords: COVID-19; COVID-19 vaccination; Cancer patients.

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Conflict of interest statement

Conflict of interest: The authors declare that there are no conflicts of interest, including specific financial interests, relationships, and/or affiliations relevant to the subject matter or materials included herein.

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