Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis
Posted on 2020-06-26 - 03:55
Abstract Background Although research on the effects of comorbidities on coronavirus disease 2019 (COVID-19) patients is increasing, the risk of cancer history has not been evaluated for the mortality of patients with COVID-19. Methods In this retrospective study, we included 3232 patients with pathogen-confirmed COVID-19 who were hospitalized between January 18th and March 27th, 2020, at Tongji Hospital in Wuhan, China. Propensity score matching was used to minimize selection bias. Results In total, 2665 patients with complete clinical outcomes were analyzed. The impacts of age, sex, and comorbidities were evaluated separately using binary logistic regression analysis. The results showed that age, sex, and cancer history are independent risk factors for mortality in hospitalized COVID-19 patients. COVID-19 patients with cancer exhibited a significant increase in mortality rate (29.4% vs. 10.2%, P < 0.0001). Furthermore, the clinical outcomes of patients with hematological malignancies were worse, with a mortality rate twice that of patients with solid tumors (50% vs. 26.1%). Importantly, cancer patients with complications had a significantly higher risk of poor outcomes. One hundred nine cancer patients were matched to noncancer controls in a 1:3 ratio by propensity score matching. After propensity score matching, the cancer patients still had a higher risk of mortality than the matched noncancer patients (odds ratio (OR) 2.98, 95% confidence interval (95% CI) 1.76–5.06). Additionally, elevations in ferritin, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, procalcitonin, prothrombin time, interleukin-2 (IL-2) receptor, and interleukin-6 (IL-6) were observed in cancer patients. Conclusions We evaluated prognostic factors with epidemiological analysis and highlighted a higher risk of mortality for cancer patients with COVID-19. Importantly, cancer history was the only independent risk factor for COVID-19 among common comorbidities, while other comorbidities may act through other factors. Moreover, several laboratory parameters were significantly different between cancer patients and matched noncancer patients, which may indicate specific immune and inflammatory reactions in COVID-19 patients with cancer.
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Meng, Yifan; Lu, Wanrong; Guo, Ensong; Liu, Jia; Yang, Bin; Wu, Ping; et al. (2020). Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.5016671.v2
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AUTHORS (22)
YM
Yifan Meng
WL
Wanrong Lu
EG
Ensong Guo
JL
Jia Liu
BY
Bin Yang
PW
Ping Wu
SL
Shitong Lin
TP
Ting Peng
YF
Yu Fu
FL
Fuxia Li
ZW
Zizhuo Wang
YL
Yuan Li
RX
Rourou Xiao
CL
Chen Liu
YH
Yuhan Huang
FL
Funian Lu
XW
Xue Wu
LY
Lixin You
DM
Ding Ma
CS
Chaoyang Sun