Clinical characteristics, risk factors and outcomes of cancer patients with COVID‐19: A population‐based study
Abstract Introduction Cancer patients may be susceptible to poorer outcomes in COVID‐19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions. Methods This was a populat...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.4888 |
| _version_ | 1797950874620788736 |
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| author | Jiandong Zhou Ishan Lakhani Oscar Chou Keith Sai Kit Leung Teddy Tai Loy Lee Michelle Vangi Wong Zhen Li Abraham Ka Chung Wai Carlin Chang Ian Chi Kei Wong Qingpeng Zhang Gary Tse Bernard Man Yung Cheung |
| author_facet | Jiandong Zhou Ishan Lakhani Oscar Chou Keith Sai Kit Leung Teddy Tai Loy Lee Michelle Vangi Wong Zhen Li Abraham Ka Chung Wai Carlin Chang Ian Chi Kei Wong Qingpeng Zhang Gary Tse Bernard Man Yung Cheung |
| author_sort | Jiandong Zhou |
| collection | DOAJ |
| description | Abstract Introduction Cancer patients may be susceptible to poorer outcomes in COVID‐19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions. Methods This was a population‐based retrospective cohort study of COVID‐19 patients who presented to Hong Kong public hospitals between 1 January 2020 and 8 December 2020. The primary outcome was a composite endpoint of requirement for intubation, ICU admission and 30‐day mortality. Results The following study consisted of 6089 COVID‐19 patients (median age 45.9 [27.8.1–62.7] years; 50% male), of which 142 were cancer subjects. COVID‐19 cancer patients were older at baseline and tended to present with a higher frequency of comorbidities, including diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, ventricular tachycardia/fibrillation and gastrointestinal bleeding (p < 0.05). These subjects also likewise tended to present with higher serum levels of inflammatory markers, including D‐dimer, lactate dehydrogenase, high sensitivity troponin‐I and C‐reactive protein. Multivariate Cox regression showed that any type of cancer presented with an almost four‐fold increased risk of the primary outcome (HR: 3.77; 95% CI: 1.63–8.72; p < 0.002) after adjusting for significant demographics, Charlson comorbidity index, number of comorbidities, past comorbidities and medication history. This association remained significant when assessing those with colorectal (HR: 5.07; 95% CI: 1.50–17.17; p < 0.009) and gastrointestinal malignancies (HR: 3.79; 95% CI: 1.12–12.88; p < 0.03), but not with lung, genitourinary, or breast malignancies, relative to their respective cancer‐free COVID‐19 counterparts. Conclusions COVID‐19 cancer patients are associated with a significantly higher risk of intubation, ICU admission and/or mortality. |
| first_indexed | 2024-04-10T22:21:55Z |
| format | Article |
| id | doaj.art-5fd2d501a10e46b7bf4a30aa81671c51 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-10T22:21:55Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-5fd2d501a10e46b7bf4a30aa81671c512023-01-17T17:10:24ZengWileyCancer Medicine2045-76342023-01-0112128729610.1002/cam4.4888Clinical characteristics, risk factors and outcomes of cancer patients with COVID‐19: A population‐based studyJiandong Zhou0Ishan Lakhani1Oscar Chou2Keith Sai Kit Leung3Teddy Tai Loy Lee4Michelle Vangi Wong5Zhen Li6Abraham Ka Chung Wai7Carlin Chang8Ian Chi Kei Wong9Qingpeng Zhang10Gary Tse11Bernard Man Yung Cheung12Nuffield Department of Medicine University of Oxford Oxford UKCardiovascular Analytics Group, Laboratory of Cardiovascular Physiology Hong Kong ChinaLi Ka Shing Faculty of Medicine University of Hong Kong Hong Kong ChinaAston Medical School Aston University Birmingham UKEmergency Medicine Unit University of Hong Kong Hong Kong ChinaCardiovascular Analytics Group, Laboratory of Cardiovascular Physiology Hong Kong ChinaDepartment of Radiology Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology Wuhan ChinaEmergency Medicine Unit University of Hong Kong Hong Kong ChinaDivision of Neurology, Department of Medicine University of Hong Kong Hong Kong ChinaDepartment of Pharmacology and Pharmacy University of Hong Kong Hong Kong ChinaNuffield Department of Medicine University of Oxford Oxford UKCardiovascular Analytics Group, Laboratory of Cardiovascular Physiology Hong Kong ChinaDivision of Clinical Pharmacology, Department of Medicine University of Hong Kong Hong Kong ChinaAbstract Introduction Cancer patients may be susceptible to poorer outcomes in COVID‐19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions. Methods This was a population‐based retrospective cohort study of COVID‐19 patients who presented to Hong Kong public hospitals between 1 January 2020 and 8 December 2020. The primary outcome was a composite endpoint of requirement for intubation, ICU admission and 30‐day mortality. Results The following study consisted of 6089 COVID‐19 patients (median age 45.9 [27.8.1–62.7] years; 50% male), of which 142 were cancer subjects. COVID‐19 cancer patients were older at baseline and tended to present with a higher frequency of comorbidities, including diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, ventricular tachycardia/fibrillation and gastrointestinal bleeding (p < 0.05). These subjects also likewise tended to present with higher serum levels of inflammatory markers, including D‐dimer, lactate dehydrogenase, high sensitivity troponin‐I and C‐reactive protein. Multivariate Cox regression showed that any type of cancer presented with an almost four‐fold increased risk of the primary outcome (HR: 3.77; 95% CI: 1.63–8.72; p < 0.002) after adjusting for significant demographics, Charlson comorbidity index, number of comorbidities, past comorbidities and medication history. This association remained significant when assessing those with colorectal (HR: 5.07; 95% CI: 1.50–17.17; p < 0.009) and gastrointestinal malignancies (HR: 3.79; 95% CI: 1.12–12.88; p < 0.03), but not with lung, genitourinary, or breast malignancies, relative to their respective cancer‐free COVID‐19 counterparts. Conclusions COVID‐19 cancer patients are associated with a significantly higher risk of intubation, ICU admission and/or mortality.https://doi.org/10.1002/cam4.4888cancerCOVID‐19intensive care unitintubationmortality |
| spellingShingle | Jiandong Zhou Ishan Lakhani Oscar Chou Keith Sai Kit Leung Teddy Tai Loy Lee Michelle Vangi Wong Zhen Li Abraham Ka Chung Wai Carlin Chang Ian Chi Kei Wong Qingpeng Zhang Gary Tse Bernard Man Yung Cheung Clinical characteristics, risk factors and outcomes of cancer patients with COVID‐19: A population‐based study Cancer Medicine cancer COVID‐19 intensive care unit intubation mortality |
| title | Clinical characteristics, risk factors and outcomes of cancer patients with COVID‐19: A population‐based study |
| title_full | Clinical characteristics, risk factors and outcomes of cancer patients with COVID‐19: A population‐based study |
| title_fullStr | Clinical characteristics, risk factors and outcomes of cancer patients with COVID‐19: A population‐based study |
| title_full_unstemmed | Clinical characteristics, risk factors and outcomes of cancer patients with COVID‐19: A population‐based study |
| title_short | Clinical characteristics, risk factors and outcomes of cancer patients with COVID‐19: A population‐based study |
| title_sort | clinical characteristics risk factors and outcomes of cancer patients with covid 19 a population based study |
| topic | cancer COVID‐19 intensive care unit intubation mortality |
| url | https://doi.org/10.1002/cam4.4888 |
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