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Outcomes of the 2019 novel coronavirus in patients with or without a history of cancer: a multi-centre North London experience
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Outcomes of the 2019 novel coronavirus in patients with or without a history of cancer: a multi-centre North London experience
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Journal Article
Outcomes of the 2019 novel coronavirus in patients with or without a history of cancer: a multi-centre North London experience
2020
Overview
Background:
This study aims to compare the outcomes of COVID-19-positive disease in patients with a
history of cancer to those without.
Methods:
We retrospectively collected clinical data and outcomes of COVID-19 positive cancer
patients treated consecutively in five North London hospitals (cohort A). Outcomes
recorded included time interval between most recent anti-cancer treatment and admission,
severe outcome [a composite endpoint of intensive care unit (ITU) admission, ventilation
and/or death] and mortality. Outcomes were compared with consecutively admitted COVID-19
positive patients, without a history of cancer (cohort B), treated at the primary centre
during the same time period (1 March–30 April 2020). Patients were matched for age,
gender and comorbidity.
Results:
The median age in both cohorts was 74 years, with 67% male, and comprised of 30
patients with cancer, and 90 without (1:3 ratio). For cohort B, 579 patients without a
history of cancer and consecutively admitted were screened from the primary London
hospital, 105 were COVID-19 positive and 90 were matched and included. Excluding cancer,
both cohorts had a median of two comorbidities. The odds ratio (OR) for mortality,
comparing patients with cancer to those without, was 1.05 [95% confidence interval (CI)
0.4–2.5], and severe outcome (OR 0.89, 95% CI 0.4–2.0) suggesting no increased risk of
death or a severe outcome in patients with cancer. Cancer patients who received systemic
treatment within 28 days had an OR for mortality of 4.05 (95% CI 0.68–23.95),
p = 0.12. On presentation anaemia, hypokalaemia, hypoalbuminaemia and
hypoproteinaemia were identified predominantly in cohort A. Median duration of admission
was 8 days for cancer patients and 7 days for non-cancer.
Conclusion:
A diagnosis of cancer does not appear to increase the risk of death or a severe outcome
in COVID-19 patients with cancer compared with those without cancer. If a second spike
of virus strikes, rational decision making is required to ensure optimal cancer
care.
