Prognostic Value of Pro-Inflammatory Neutrophils and C-Reactive Protein in Cancer Patient With Coronavirus Disease 2019: A Multi-Center, Retrospective Study

Bo Zhang; Yuanhang Yu; Shawna M Hubert; Yue Zhang; Jianhua Lu; Shihua Liu; Fang Xie; Liang Zhao; Xiao Lei; Wei Deng; Jianying Chen; Yunqiao Li

doi:10.3389/fphar.2020.576994

Prognostic Value of Pro-Inflammatory Neutrophils and C-Reactive Protein in Cancer Patient With Coronavirus Disease 2019: A Multi-Center, Retrospective Study

Front Pharmacol. 2020 Oct 22:11:576994. doi: 10.3389/fphar.2020.576994. eCollection 2020.

Authors

Bo Zhang¹, Yuanhang Yu¹, Shawna M Hubert², Yue Zhang¹, Jianhua Lu³, Shihua Liu⁴, Fang Xie⁵, Liang Zhao⁶, Xiao Lei⁷, Wei Deng⁷, Jianying Chen⁸, Yunqiao Li⁹

Affiliations

¹ Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Thoracic Medical Oncology, Department of Genomic Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, United States.
³ Department of General Surgery, Chibi People's Hospital, Chibi, China.
⁴ Department of Infectious Diseases, Zaoyang First People's Hospital, Zaoyang, China.
⁵ Department of Respiratory Intensive Care Unit, Ezhou Central Hospital, Ezhou, China.
⁶ Department of General Surgery, Huangshi Central Hospital, Huangshi, China.
⁷ Department of General Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁸ Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁹ Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Background: At present, the epidemic of the novel coronavirus disease 2019 (COVID-19) has quickly engulfed the world. Inflammatory cytokines are associated with the severity and outcomes of patients with COVID-19. However, the prognostic value of pro-inflammatory factors in cancer patients with COVID-19 are unknown. Methods: A multi-center, retrospective, cross-sectional study, based on five designated tertiary hospitals for the treatment of COVID-19 in Hubei Province, China. 112 cancer patients with COVID-19, and 105 COVID-19 patients without cancer were enrolled in the study between January 1st, 2020 and April 30th, 2020. The risk assessment of pro-inflammatory factors for disease severity and clinical adverse outcomes was identified by univariable and multivariable logistic regression models. Results: Of the 112 cancer patients with COVID-19, 40 (35.7%) patients were in critical condition and 18 (16.1%) patients died unfortunately. Univariate and multivariate analysis demonstrated that hemoglobin level and pro-inflammatory neutrophils and C-reactive protein (CRP), can be used as independent factors affecting the severity of COVID-19; Meanwhile, pro-inflammatory neutrophils and CRP can be used as an independent influencing factor for adverse clinical outcome of death. Moreover, the dynamic changes of neutrophils and CRP were also presented, and compared with COVID-19 patients without cancer, cancer patients with COVID-19 showed higher neutrophil counts and CRP levels. Conclusion: In cancer patients with COVID-19, the significant increase in pro-inflammatory neutrophils and CRP indicated a more critical illness and adverse clinical outcome, and pro-inflammatory neutrophils and CRP played a greater adverse role compare with COVID-19 patients without cancer, which may be the cause of critical illness and adverse clinical outcomes of cancer patients with COVID-19.

Keywords: C-reactive protein; cancer; coronavirus disease 2019; neutrophils; pro-inflammatory.