Risk of COVID-19 death in cancer patients: an analysis from Guy's Cancer Centre and King's College Hospital in London.
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Russell Beth, Moss Charlotte L, Shah Vallari, Ko Thinzar Ko, Palmer Kieran, Sylva Rushan, George Gincy, Monroy-Iglesias Maria J, Patten Piers, Ceesay Muhammed Mansour, Benjamin Reuben, Potter Victoria, Pagliuca Antonio, Papa Sophie, Irshad Sheeba, Ross Paul, Spicer James, Kordasti Shahram, Crawley Danielle, Wylie Harriet, Cahill Fidelma, Haire Anna, Zaki Kamarul, Sita-Lumsden Ailsa, Josephs Debra, Enting Deborah, Swampillai Angela, Sawyer Elinor, D'Souza Andrea, Gomberg Simon, Harrison Claire, Fields Paul, Wrench David, Rigg Anne, Sullivan Richard, Kulasekararaj Austin, Guy’s Cancer Real World Evidence, Dolly Saoirse, Van Hemelrijck Mieke
Аннотация
METHODS: Data on all cancer patients with a positive reverse transcription-polymerase chain reaction swab for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) at Guy's Cancer Centre and King's College Hospital between 29 February and 31 July 2020 was used. Cox proportional hazards regression was performed to identify which factors were associated with COVID-19 mortality.
RESULTS: Three hundred and six SARS-CoV-2-positive cancer patients were included. Seventy-one had mild/moderate and 29% had severe COVID-19. Seventy-two patients died of COVID-19 (24%), of whom 35 died <7 days. Male sex [hazard ratio (HR): 1.97 (95% confidence interval (CI): 1.15-3.38)], Asian ethnicity [3.42 (1. 59-7.35)], haematological cancer [2.03 (1.16-3.56)] and a cancer diagnosis for >2-5 years [2.81 (1.41-5.59)] or ≥5 years were associated with an increased mortality. Age >60 years and raised C-reactive protein (CRP) were also associated with COVID-19 death. Haematological cancer, a longer-established cancer diagnosis, dyspnoea at diagnosis and raised CRP were indicative of early COVID-19-related death in cancer patients (<7 days from diagnosis).
CONCLUSIONS: Findings further substantiate evidence for increased risk of COVID-19 mortality for male and Asian cancer patients, and those with haematological malignancies or a cancer diagnosis >2 years. These factors should be accounted for when making clinical decisions for cancer patients.