Determinants of COVID-19 Disease Severity in Patients With Cancer
Main result
423 cancer patients diagnosed with COVID-19 (56% were over the age of 60, 59% had a pre-existing comorbidity other than cancer).
In the cohort, 168 (40%) were hospitalized and 87 (20%) developed severe respiratory disease, of which 47 (11%) required high-flow oxygen and 40 (9%) required mechanical ventilation. The disease in 7 pediatric patients was mild and uncomplicated.
The overall case fatality rate was 12% (51 of 423). The number of deaths for hospitalized patients and in intensive care units was 24% (41 of 168) and 35% (17 of 48), respectively.
In the multivariate analysis, the following risk factors were independently associated with hospitalization and with a severe form of the infection: non-Caucasian ethnic origin, hematological malignancy, a composite criterion as chronic lymphopenia and / or use of corticosteroids and immunotherapy by checkpoint inhibitor (anti-CTLA-4, anti-PD-1, anti-PD-L1).
Post-hoc analysis on checkpoint inhibitors: distinct effects of lung cancer and treatment on hospitalization and severe forms.
Takeaways
Strength of evidence Weak
Letter to the Editor
A monocentric retrospective cohort study
n=423
Retrospective, unblinded data collection from medical records, no details on multiple data entry and data verification
Objectives
Method
Retrospective cohort study of patients with cancer diagnosed COVID-19, monocentric (New York).
Inclusion criteria: from March 10 to April 7, 2020, all consecutive cases (adults and pediatric) with cancer and COVID-19 (symptomatic and confirmed) in the laboratory were included. Follow-up period of at least 30 days in the absence of death in the meantime.
Exclusion criteria: outpatients with missing clinical information and asymptomatic individuals tested under diagnostic screening protocols before surgery or myeloablative chemotherapy were excluded.
Data were collected in electronic medical records.
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