Frontiers in Oncology (Jul 2020)

Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London

  • Beth Russell,
  • Charlotte Moss,
  • Sophie Papa,
  • Sophie Papa,
  • Sheeba Irshad,
  • Sheeba Irshad,
  • Paul Ross,
  • James Spicer,
  • James Spicer,
  • Shahram Kordasti,
  • Shahram Kordasti,
  • Danielle Crawley,
  • Danielle Crawley,
  • Harriet Wylie,
  • Fidelma Cahill,
  • Anna Haire,
  • Kamarul Zaki,
  • Fareen Rahman,
  • Ailsa Sita-Lumsden,
  • Debra Josephs,
  • Debra Josephs,
  • Deborah Enting,
  • Deborah Enting,
  • Mary Lei,
  • Sharmistha Ghosh,
  • Claire Harrison,
  • Claire Harrison,
  • Angela Swampillai,
  • Elinor Sawyer,
  • Elinor Sawyer,
  • Andrea D'Souza,
  • Simon Gomberg,
  • Paul Fields,
  • David Wrench,
  • Kavita Raj,
  • Mary Gleeson,
  • Kate Bailey,
  • Richard Dillon,
  • Richard Dillon,
  • Matthew Streetly,
  • Anne Rigg,
  • Richard Sullivan,
  • Saoirse Dolly,
  • Mieke Van Hemelrijck,
  • Mieke Van Hemelrijck

DOI
https://doi.org/10.3389/fonc.2020.01279
Journal volume & issue
Vol. 10

Abstract

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Background: There is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies.Methods: We used data from a single large UK Cancer Center to assess the demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February and 12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death.Results: 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with a severe case of the disease. An initial cancer diagnosis >24 months before COVID-19 [OR: 1.74 (95% CI: 0.71–4.26)], presenting with fever [6.21 (1.76–21.99)], dyspnea [2.60 (1.00–6.76)], gastro-intestinal symptoms [7.38 (2.71–20.16)], or higher levels of C-reactive protein [9.43 (0.73–121.12)] were linked with greater COVID-19 severity. During a median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Being of Asian ethnicity [3.73 (1.28–10.91)], receiving palliative treatment [5.74 (1.15–28.79)], having an initial cancer diagnosis >24 months before [2.14 (1.04–4.44)], dyspnea [4.94 (1.99–12.25)], and increased CRP levels [10.35 (1.05–52.21)] were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin [0.04 (0.01–0.04)].Conclusions: A longer-established diagnosis of cancer was associated with increased severity of infection as well as COVID-19 death, possibly reflecting the effects a more advanced malignant disease has on this infection. Asian ethnicity and palliative treatment were also associated with COVID-19 death in cancer patients.

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