428P - Clinical characteristics, laboratory parameters, and hospital outcomes of COVID-19 among patients with and without cancer: A retrospective cohort study

Background

Cancer patients are at increased risk of infection due to immunosuppression, poor nutrition, and other health problems. Various studies have shown that cancer patients have a higher risk of serious complications related to Coronavirus disease (COVID-19) than patients without cancer, however, the strength of associated varied significantly across the studies. We aim to analyze the differences in the clinical characteristics, laboratory parameters, and hospital outcomes of COVID-19 among patients with and without cancer.

Methods

This was a retrospective study of 1873 patients including 102 cancer patients who presented with SARS-CoV-2 infection at our hospital. Our primary outcome was the in-hospital mortality rate due to COVID-19 and the secondary outcome was a comparison of demographic, clinical, laboratory, and treatment parameters of cancer patients compared to non-cancer patients. Multivariate logistic regression models were fitted to identify factors predictive of disease progression in the hospital, including death.

Results

Cancer patients had a higher in-hospital mortality rate than non-cancer patients (26.5 vs 21.2 %, P=0.211). The proportion of people with anemia, thrombocytopenia, and leukopenia was significantly higher in the cancer group. The median value of inflammatory markers (ferritin, D-dimer, and IL-6) in the cancer group is approximately two times than non-cancer group. The odds of worsening [1.73 (1.01-2.95)] and death [2.83 (1.46-5.47)] during hospital stay were significantly higher in cancer patients. Hematological malignancies had higher odds of developing critical illness [4.96 (1.57-15.7)] and receiving mechanical ventilation [4.35 (1.27-15.0)] compared to non-cancer cases. In cancer patients, breathlessness and hypoxia at presentation were significant predictors of mortality when adjusted for other clinical features.

Conclusions

Cancer patients with COVID-19 infection have abnormally high inflammatory responses compared with non-cancer patients and the development of breathlessness and hypoxia are important predictors of mortality. Patients with hematological malignancies have a higher risk of developing serious disease.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.