Published time: 23 March 2020
Authors: L. Zhang, F. Zhu, L. Xie, C. Wang, J. Wang, R. Chen, P. Jia, H.Q. Guan, L. Peng, Y. Chen, P. Peng, P. Zhang, Q. Chu, Q. Shen, Y. Wang, S.Y. Xu, J.P. Zhao, M. Zhou
Keywords: COVID-19, cancer, retrospective case study, severe clinical events
Background: Cancer patients are regarded as a highly vulnerable group in the current Coronavirus Disease 2019 (COVID-19) pandemic. To date, the clinical characteristics of COVID-19-infected cancer patients are largely unknown.
Patients and methods: In this retrospective cohort study, we included cancer patients with laboratory confirmed COVID-19 from three designated hospitals in Wuhan, China. The clinical data were collected from medical records from Jan 13, 2020, to Feb 26, 2020. Univariate and multivariate analyses were performed to assess the risk factors associated with severe events defined as a condition requiring admission to an intensive care unit, the use of mechanical ventilation, or death.
Results: 28 COVID-19-infected cancer patients were included; 17 (60.7%) patients were male. Median age was 65.0 years (IQR:56.0-70.0). Lung cancer was the most frequent cancer type (7, 25.0%). 8 (28.6%) patients were suspected to be from hospital-associated transmission. The following clinical features were shown in our cohort: fever (23, 82.1%), dry cough (22, 81%) and dyspnoea (14, 50.0%), along with lymphopaenia (23, 82.1%), high level of high-sensitivity C-reactive protein (23, 82.1%), anaemia (21, 75.0%) and hypoproteinaemia (25, 89.3%). The common chest CT findings were ground-glass opacity (21, 75.0%) and patchy consolidation (13, 46.3%). 15 (53.6%) patients had severe events and mortality was 28.6%. If the last anti-tumour treatment was within 14 days, it significantly increased the risk of developing severe events (HR=4.079, 95%CI 1.086-15.322, P=0.037). Furthermore, patchy consolidation on CT on admission was associated with a higher risk for developing severe events (HR=5.438, 95%CI 1.498-19.748, P=0.010).
Conclusions: Cancer patients show deteriorating conditions and poor outcomes from the COVID-19 infection. It is recommended that cancer patients receiving anti-tumour treatments should have vigorous screening for COVID-19 infection and should avoid treatments causing immunosuppression or have their dosages decreased in case of COVID-19 co-infection.
Clinical characteristics of COVID-19-infected cancer patients A retrospective case study in three hospitals within Wuhan, China