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Article: Clinical characteristics, risk factors and outcomes of cancer patients with COVID-19: A population-based study

TitleClinical characteristics, risk factors and outcomes of cancer patients with COVID-19: A population-based study
Authors
Issue Date2022
Citation
Cancer Medicine, 2022 How to Cite?
AbstractIntroduction 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.
Persistent Identifierhttp://hdl.handle.net/10722/313409

 

DC FieldValueLanguage
dc.contributor.authorZhou, J-
dc.contributor.authorLakhani, I-
dc.contributor.authorChou, O-
dc.contributor.authorLeung, KSK-
dc.contributor.authorLee, TTL-
dc.contributor.authorWong, MV-
dc.contributor.authorLI, Z-
dc.contributor.authorWai, KCA-
dc.contributor.authorChang, C-
dc.contributor.authorWong, ICK-
dc.contributor.authorZhang, Q-
dc.contributor.authorTse, G-
dc.contributor.authorCheung, BMY-
dc.date.accessioned2022-06-17T06:45:58Z-
dc.date.available2022-06-17T06:45:58Z-
dc.date.issued2022-
dc.identifier.citationCancer Medicine, 2022-
dc.identifier.urihttp://hdl.handle.net/10722/313409-
dc.description.abstractIntroduction 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.-
dc.languageeng-
dc.relation.ispartofCancer Medicine-
dc.titleClinical characteristics, risk factors and outcomes of cancer patients with COVID-19: A population-based study -
dc.typeArticle-
dc.identifier.emailWai, KCA: awai@hku.hk-
dc.identifier.emailWong, ICK: wongick@hku.hk-
dc.identifier.emailCheung, BMY: mycheung@hkucc.hku.hk-
dc.identifier.authorityWai, KCA=rp02261-
dc.identifier.authorityWong, ICK=rp01480-
dc.identifier.authorityCheung, BMY=rp01321-
dc.identifier.doi10.1002/cam4.4888-
dc.identifier.hkuros333482-

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