Journal Article

Risk of COVID-19 death in cancer patients: an analysis from Guy’s Cancer Centre and King’s College Hospital in London

Wrench, David, Van Hemelrijck, Mieke, Ceesay, Muhammed Mansour, Pagliuca, Antonio, Sawyer, Elinor, Kordasti, Shahram, Patten, Piers, Shah, Vallari, Wylie, Harriet, Swampillai, Angela, Ko, Thinzar Ko, Gomberg, Simon, Josephs, Debra, Ross, Paul, Haire, Anna, Zaki, Kamarul, Enting, Deborah, Dolly, Saoirse, Moss, Charlotte L., Rigg, Anne, Crawley, Danielle, Sita-Lumsden, Ailsa, Sullivan, Richard, Irshad, Sheeba, D’Souza, Andrea, Palmer, Kieran, Fields, Paul, Kulasekararaj, Austin, Sylva, Rushan, Papa, Sophie, Monroy-Iglesias, Maria J., Benjamin, Reuben, Potter, Victoria, Harrison, Claire, Cahill, Fidelma, Russell, Beth, Spicer, James, George, Gincy

2021

Overview

Background Using an updated dataset with more patients and extended follow-up, we further established cancer patient characteristics associated with COVID-19 death. 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.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/308/575 / 692/4028 / 692/499 / Adult / Aged / Aged, 80 and over / Biomedical and Life Sciences / Biomedicine / Blood cancer / C-reactive protein / Cancer / Cancer Research / Coronaviruses / COVID-19 / COVID-19 - complications / COVID-19 - epidemiology / COVID-19 - pathology / COVID-19 - virology / Death / Diagnosis / Drug Resistance / Dyspnea / Epidemiology / Female / Hematologic Neoplasms - complications / Hematologic Neoplasms - epidemiology / Hematologic Neoplasms - pathology / Hematologic Neoplasms - virology / Hematology / Hospitals / Humans / London - epidemiology / Male / Medical diagnosis / Middle Aged / Molecular Medicine / Mortality / Neoplasms - complications / Neoplasms - epidemiology / Neoplasms - pathology / Neoplasms - virology / Oncology / Patients / Polymerase chain reaction / Respiration / Reverse transcription / Risk Factors / SARS-CoV-2 - pathogenicity / Severe acute respiratory syndrome coronavirus 2 / Sex ratio