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. 2025 May 1;17(9):1536.
doi: 10.3390/cancers17091536.

SARS-CoV-2 Infection Risk and COVID-19 Prevalence and Mortality in Cancer Patients During the First Wave of COVID-19 Pandemic in a Virus Epicenter in Northern Italy

Matilde Corianò  1   2 , Luca Isella  3 , Chiara Tommasi  1   2 , Benedetta Pellegrino  1 , Maria Michiara  1 , Daniela Boggiani  1 , Francesca Pucci  1 , Alessandro Leonetti  1 , Sabrina Bizzoco  4 , Paola Affanni  2 , Licia Veronesi  2 , Elena Rapacchi  1 , Olga Serra  5 , Paolo Sgargi  1 , Giuseppe Maglietta  6 , Antonino Musolino  5   7
Affiliations

SARS-CoV-2 Infection Risk and COVID-19 Prevalence and Mortality in Cancer Patients During the First Wave of COVID-19 Pandemic in a Virus Epicenter in Northern Italy

Matilde Corianò et al. Cancers (Basel). .

Abstract

Background/objectives: Cancer patients are more vulnerable to SARS-CoV-2 infection and COVID-19 due to their immunocompromised status. This study aims to evaluate the risk of SARS-CoV-2 infection, as well as COVID-19 prevalence and mortality, in cancer patients during the first wave of the COVID-19 pandemic in a virus epicenter of Northern Italy. Methods: This retrospective analysis included 40,148 prevalent cancer patients from the province of Parma, Italy, between February and June 2020. Patients were identified from health system records and classified by cancer subtype, treatment status, and COVID-19 diagnosis. The risk of infection and mortality was analyzed using odds ratios (OR) and hazard ratios (HR). Results: Among cancer patients, those on active cancer treatment had a higher cumulative risk of all-cause death (HR 1.83, p < 0.000268). Cancer subtype significantly impacted COVID-19 outcomes, with breast cancer patients showing lower incidence and mortality compared to those with lung, colorectal, or bladder cancers. Conclusions: Cancer patients, especially those on active treatment, are at increased risk of COVID-19 infection and death. Tailored prevention strategies, including prioritization of vaccination and careful management of cancer treatments, are crucial to mitigate risks during pandemics. These findings provide valuable insights for clinical decision-making in oncological care during public health crises.

Keywords: COVID-19; cancer; death; incidence.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram. * Only cancer patients with confirmed residency in the province of Parma and a clinical diagnosis of COVID-19 (irrespective of any SARS-CoV-2-positive tests) were included in the analysis of COVID-19 prevalence and mortality.
Figure 2
Figure 2
Cumulative incidence of COVID-19 diagnosis among “NHS users” and “non-NHS users” in cancer patients. [HR: 1.18, 95% CI: 1.04–1.34; p < 0.011].
Figure 3
Figure 3
Cumulative incidence of COVID-19 diagnosis in the overall population of cancer patients according to cancer subtypes.
Figure 4
Figure 4
(a). Cumulative incidence of all-causes death among the hospitalized cancer patients with COVID-19 diagnosis according to “on cancer treatment” status [HR: 1.83 (95% CI: 1.32–2.53, p < 0.000268)]. (b). Cumulative incidence of all-causes death among the hospitalized cancer patients with cancer diagnosis with COVID-19 according to cancer subtypes.
Figure 5
Figure 5
Cluster analysis. On the top, the bidimensional plot from the MCA displays each patient, color-coded according to their assigned cluster, as identified through the HCPC analysis. At the bottom, the dendrogram illustrates the hierarchical clustering process, highlighting the division of the overall sample into three distinct clusters.
See this image and copyright information in PMC

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