Outcomes of novel coronavirus disease 2019 (COVID-19) infection in 107 patients with cancer from Wuhan, China

Cancer. 2020 Sep 1;126(17):4023-4031. doi: 10.1002/cncr.33042. Epub 2020 Jun 23.

Abstract

Background: Patients with cancer have a higher risk of coronavirus disease 2019 (COVID-19) than noncancer patients. The authors conducted a multicenter retrospective study to investigate the clinical manifestations and outcomes of patients with cancer who are diagnosed with COVID-19.

Methods: The authors reviewed the medical records of hospitalized patients who were treated at 5 hospitals in Wuhan City, China, between January 5 and March 18, 2020. Clinical parameters relating to cancer history (type and treatment) and COVID-19 were collected. The primary outcome was overall survival (OS). Secondary analyses were the association between clinical factors and severe COVID-19 and OS.

Results: A total of 107 patients with cancer were diagnosed with COVID-19, with a median age of 66 years (range, 37-98 years). Lung (21 patients; 19.6%), gastrointestinal (20 patients; 18.7%), and genitourinary (20 patients; 18.7%) cancers were the most common cancer diagnoses. A total of 37 patients (34.6%) were receiving active anticancer treatment when diagnosed with COVID-19, whereas 70 patients (65.4%) were on follow-up. Overall, 52.3% of patients (56 patients) developed severe COVID-19; this rate was found to be higher among patients receiving anticancer treatment than those on follow-up (64.9% vs 45.7%), which corresponded to an inferior OS in the former subgroup of patients (hazard ratio, 3.365; 95% CI, 1.455-7.782 [P = .005]). The detrimental effect of anticancer treatment on OS was found to be independent of exposure to systemic therapy (case fatality rate of 33.3% [systemic therapy] vs 43.8% [nonsystemic therapy]).

Conclusions: The results of the current study demonstrated that >50.0% of infected patients with cancer are susceptible to severe COVID-19. This risk is aggravated by simultaneous anticancer treatment and portends for a worse survival, despite treatment for COVID-19.

Keywords: anticancer treatment; cancer; case fatality rate; coronavirus disease 2019 (COVID-19); systemic therapy.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Betacoronavirus / genetics*
  • COVID-19
  • China / epidemiology
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Neoplasms / epidemiology*
  • Neoplasms / mortality*
  • Pandemics
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / virology
  • Retrospective Studies
  • Risk
  • SARS-CoV-2
  • Severity of Illness Index
  • Steroids / therapeutic use
  • Survival Rate
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Antiviral Agents
  • Immunoglobulins, Intravenous
  • Steroids