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Cancer Med . Clinical characteristics, laboratory parameters and outcomes of COVID-19 in cancer and non-cancer patients from a tertiary Cancer Cent

tetano

Editor, Senior Moderator
Cancer Med


. 2021 Nov 16.
doi: 10.1002/cam4.4379. Online ahead of print.
Clinical characteristics, laboratory parameters and outcomes of COVID-19 in cancer and non-cancer patients from a tertiary Cancer Centre in India


Sumeet P Mirgh[SUP] 1 2 [/SUP], Anant Gokarn[SUP] 1 2 [/SUP], Akhil Rajendra[SUP] 2 3 [/SUP], Ashwini More[SUP] 4 [/SUP], Sujit Kamtalwar[SUP] 4 [/SUP], Kritika S Katti[SUP] 3 [/SUP], Anuj Singh[SUP] 3 [/SUP], Vasu Babu Goli[SUP] 3 [/SUP], Rahul Ravind[SUP] 3 [/SUP], Ravikrishna Madala[SUP] 3 [/SUP], Sangeeta Kakoti[SUP] 5 [/SUP], Priyamvada Maitre[SUP] 5 [/SUP], Sachin Punatar[SUP] 1 2 [/SUP], Akanksha Chichra[SUP] 1 2 [/SUP], Amar Patil[SUP] 4 [/SUP], Bhakti Trivedi[SUP] 2 6 [/SUP], Amit Joshi[SUP] 2 3 [/SUP], Nikhil Patkar[SUP] 2 7 [/SUP], Prashant Tembhare[SUP] 2 7 [/SUP], Twinkle Khanka[SUP] 2 7 [/SUP], Sweta Rajpal[SUP] 2 7 [/SUP], Gaurav Chatterjee[SUP] 2 7 [/SUP], Sadhana Kannan[SUP] 8 [/SUP], P G Subramanian[SUP] 2 7 [/SUP], Vedang Murthy[SUP] 5 [/SUP], Nitin Shetty[SUP] 2 9 [/SUP], Preeti Chavan[SUP] 2 10 [/SUP], Vivek Bhat[SUP] 2 11 [/SUP], Sudhir Nair[SUP] 2 12 [/SUP], Navin Khattry[SUP] 1 2 [/SUP], Sudeep Gupta[SUP] 2 3 [/SUP]



Affiliations

Abstract

Background: There is paucity of data regarding clinical characteristics, laboratory parameters and outcomes of coronavirus disease (COVID-19) in cancer versus non-cancer patients, particularly from India.
Materials and methods: This was an observational, single-centre, retrospective analysis of patients with laboratory-confirmed COVID-19 hospitalised in our institution between 22 May 2020 and 1 December 2020. We compared baseline clinical characteristics, laboratory parameters and outcomes of COVID-19 (overall mortality, time to discharge) between cancer and non-cancer patients.
Results: A total of 200 COVID-19 infection episodes were analysed of which 109 (54.5%) were patients with cancer and 91 (45.5%) were patients without cancer. The median age was 43 (interquartile range [IQR]:32-57), 51 (IQR: 33-62) and 38 (IQR: 31.5-49.3) years; of whole cohort, cancer and non-cancer patients, respectively. Comparison of outcomes showed that oxygen requirement (31.2% [95% CI: 22.6-40.7] vs. 17.6% [95% CI: 10.4-26.9]; p = 0.03), median time to discharge (11 days [IQR: 6.75-16] vs. 6 days [IQR: 3-9.75]; p < 0.001) and mortality (10.0% [95% CI: 5.2-17.3] vs. 1.1% [95% CI: 0.03-5.9]; p = 0.017) were significantly higher in patients with cancer. In univariable analysis, factors associated with higher mortality in the whole cohort included diagnosis of cancer (10.1% vs. 1.1%; p = 0.027; odds ratio [OR]: 7.04), age ≥60 (17.4% vs. 2.6%; p = 0.001; OR: 7.38), oxygen requirement (22% vs. 0.6%; p < 0.001; OR: 29.01), chest infiltrates (19.2% vs. 1.4%; p < 0.001; OR: 22.65), baseline absolute lymphocyte count <1 × 10[SUP]9[/SUP] /L (10.8% vs. 1.9%; p = 0.023; OR:5.1), C-reactive protein >1 mg% (12.8% vs. 0%; p = 0.027; OR: 24.69), serum procalcitonin >0.05 ng/ml (22.65% vs. 0%; p = 0.004; OR: 4.49) and interleukin-6 >6 pg/ml (10.8% vs. 1.3%; p = 0.036; OR: 3.08). In multivariable logistic regression, factors significantly associated with mortality were oxygen requirement (p = 0.005; OR: 13.11) and high baseline procalcitonin level (p = 0.014; OR: 37.6).
Conclusion: Cancer patients with COVID-19 have higher mortality and require longer hospital stay. High procalcitonin levels and oxygen requirement during admission are other factors that affect outcomes adversely.

Keywords: COVID-19; cancer; non-cancer; outcomes.
 
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