Risk factors for 30-day mortality in patients with cancer and COVID-19 in Turkey: A single center retrospective study
Risk factors for 30-day mortality in patients with cancer and COVID-19 in Turkey: A single center retrospective study
Aim: We aimed to investigate the factors affecting mortality in cancer patients with COVID-19. Materials and Methods: 120 cancer patients followed-up in Erciyes University Medical Oncology Department were included in the study. Patients with a diagnosed cancer over the age of 18 years and diagnosis of COVID-19 between April 1 and December 1 2020 were participated in the study. The relationship between clinical, demographic, laboratory values and 30-day mortality were evaluated using the Chi-square and Fisher’s exact test. Risk factors for mortality were identified by univariable and multivariable logistic regression models. Results: 120 cancer patients were accepted in the study and 30 (25%) had died within 30 days after COVID-19 positivity. Hospitalization rate of cancer patients with COVID-19 was 67.5% and 23 (19.2%) of patients were admitted to intensive care unit (ICU). 34.6% of hospitalized patients and 95.7% of those admitted in the ICU died within 30 days. In multivariable logistic regression analysis, it was concluded that the presence of lymphopenia (OR 2.2, 95% CI 1.54-13.6, p = 0.04), high neutrophil-lymphocyte ratio (NLR) (OR 3.1, 95% CI 1.21-9.8, p = 0.02), dyspnea (OR 2.5 95% CI 0.32-11.2, p = 0.04), lung cancer diagnoses (OR 3.3 95% CI 1.54-9.7, p = 0.03), male gender (OR 2.17 95% CI 1.1-7.3, p = 0.03) ) were determined that increased 30-day mortality. Conclusion: High incidence of cancer and the risk of immunosuppression in these patients increased the importance of COVID-19. Cancer patients with COVID-19 need to be treated more carefully because they are vulnerable to infection and can be mortal.
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- 1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
- 2. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
- 3. Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-e8.
- 4. Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR, et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395(10241):1907-18.
- 5. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-7.
- 6. Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020;323(18):1775-6.
- 7. https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/worldmap.(Access date:27.01.2021).
- 8. Yang K, Sheng Y, Huang C, Jin Y, Xiong N, Jiang K, et al. Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. Lancet Oncol. 2020;21(7):904-13.
- 9. Tian J, Yuan X, Xiao J, Zhong Q, Yang C, Liu B, et al. Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study. Lancet Oncol. 2020;21(7):893-903.
- 10. Lee LY, Cazier JB, Angelis V, Arnold R, Bisht V, Campton NA, et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet. 2020;395(10241):1919-26.
- 11. Becker PS GE AL. NCCN Clinical Practice Guidelines in Oncology: Hematopoietic Growth Factors Version 2.2020.
- 12. https://www.nccn.org/covid-19/pdf/HGF_COVID-19.pdf.(Accessdate:30.01.2021).
- 13. Ozdemir N, Dizdar O, Yazici O, Aksoy S, Dede DS, Budakoglu B, et al. Clinical features and outcomes of COVID-19 in patients with solid tumors: Turkish National Registry Data. Int J Cancer. 2020.
- 14. Dolan RD, McSorley ST, Horgan PG, Laird B, McMillan DC. The role of the systemic inflammatory response in predicting outcomes in patients with advanced inoperable cancer: Systematic review and meta-analysis. Crit Rev Oncol Hematol. 2017;116:134-46.
- 15. Templeton AJ, McNamara MG, Seruga B, Vera-Badillo FE, Aneja P, Ocana A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju124.
- 16. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-8.
- 17. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-tolymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020;81(1):e6-e12.
- 18. Klein SL, Flanagan KL. Sex differences in immune responses. Nat Rev Immunol. 2016;16(10):626-38.
- 19. Takahashi T, Ellingson MK, Wong P, Israelow B, Lucas C, Klein J, et al. Sex differences in immune responses that underlie COVID-19 disease outcomes. Nature. 2020;588(7837):315-20.
- 20. Luo J, Rizvi H, Preeshagul IR, Egger JV, Hoyos D, Bandlamudi C, et al. COVID-19 in patients with lung cancer. Ann Oncol. 2020;31(10):1386-96.