Impact of solid cancer on in-hospital mortality overall and among different subgroups of patients with COVID-19: a nationwide, population-based analysis
,
Mariana Brandão,
Sylvie Rottey,
Evandro de Azambuja,
Annouschka Laenen,
Hans Wildiers,
Peter Vuylsteke,
Annemie Rutten,
Sandrine Aspeslagh,
Christel Fontaine,
Joelle Collignon,
Willem Lybaert,
Jolanda Verheezen,
Jean-Charles Goeminne,
Wim Demey,
Dominique Van Beckhoven,
Jessika Deblonde,
Tatjana Geukens,
Kevin Punie,
Kristof Bafort,
Leïla Belkhir,
Nathalie Bossuyt,
Vincent Colombie,
Christine Daubresse,
Nicolas Dauby,
Paul De Munter,
Didier Delmarcelle,
Mélanie Delvallee,
Rémy Demeester,
Quentin Delefortrie,
Thierry Dugernier,
Xavier Holemans,
Ingrid Louviaux,
Pierre Yves Machurot,
Philippe Minette,
Saphia Mokrane,
Catherine Nachtergal,
Séverine Noirhomme,
Denis Piérard,
Camelia Rossi,
Carole Schirvel,
Erica Sermijn,
Frank Staelens,
Filip Triest,
Dominique Van Beckhoven,
Nina Van Goethem,
Jens Van Praet,
Anke Vanhoenacker,
Roeland Verstraete,
Elise Willems,
Chloé Wyndham-Thomas
Affiliations
Department of Clinical Surgery, University of Edinburgh Division of Clinical and Surgical Sciences, Edinburgh, UK
Mariana Brandão
EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
Sylvie Rottey
Aff3 0000 0004 0626 3303grid.410566.0Drug Research Unit GhentGhent University Hospital Ghent Belgium
Evandro de Azambuja
Department of Medical Oncology, Institut Jules Bordet, Bruxelles, Belgium
Annouschka Laenen
Interuniversity Institute for Biostatistics and statistical Bioinformatics, Leuven, Belgium
Hans Wildiers
Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
Peter Vuylsteke
Department of Medical Oncology, CHU UCL Namur, Namur, Belgium
Background Cancer seems to have an independent adverse prognostic effect on COVID-19-related mortality, but uncertainty exists regarding its effect across different patient subgroups. We report a population-based analysis of patients hospitalised with COVID-19 with prior or current solid cancer versus those without cancer.Methods We analysed data of adult patients registered until 24 May 2020 in the Belgian nationwide database of Sciensano. The primary objective was in-hospital mortality within 30 days of COVID-19 diagnosis among patients with solid cancer versus patients without cancer. Severe event occurrence, a composite of intensive care unit admission, invasive ventilation and/or death, was a secondary objective. These endpoints were analysed across different patient subgroups. Multivariable logistic regression models were used to analyse the association between cancer and clinical characteristics (baseline analysis) and the effect of cancer on in-hospital mortality and on severe event occurrence, adjusting for clinical characteristics (in-hospital analysis).Results A total of 13 594 patients (of whom 1187 with solid cancer (8.7%)) were evaluable for the baseline analysis and 10 486 (892 with solid cancer (8.5%)) for the in-hospital analysis. Patients with cancer were older and presented with less symptoms/signs and lung imaging alterations. The 30-day in-hospital mortality was higher in patients with solid cancer compared with patients without cancer (31.7% vs 20.0%, respectively; adjusted OR (aOR) 1.34; 95% CI 1.13 to 1.58). The aOR was 3.84 (95% CI 1.94 to 7.59) among younger patients (<60 years) and 2.27 (95% CI 1.41 to 3.64) among patients without other comorbidities. Severe event occurrence was similar in both groups (36.7% vs 28.8%; aOR 1.10; 95% CI 0.95 to 1.29).Conclusions This population-based analysis demonstrates that solid cancer is an independent adverse prognostic factor for in-hospital mortality among patients with COVID-19. This adverse effect was more pronounced among younger patients and those without other comorbidities. Patients with solid cancer should be prioritised in vaccination campaigns and in tailored containment measurements.
