Risk factors for in-hospital mortality among cancer patients with COVID-19: A cross-sectional study

Abstract

Since emerged in December 2019, in China, COVID-19 has become a major concern for people and health-care systems. Patients with medical diseases are at a higher risk of severe disease development and mortality. Cancer patients are more vulnerable to infections. Several studies demonstrated that COVID-19 is associated with a greater risk of morbidity and mortality among cancer patients. However, the risk factors for mortality among these patients are still unknown. This study aimed to identify the risk factors associated with in-hospital death among cancer patients with COVID-19. In this cross-sectional study, we analyzed demographic data, clinical characteristics and laboratory parameters of cancer patients with COVID-19 who were hospitalized in three tertiary referral hospitals in Tehran, Iran from February to May 2020. Diagnosis of COVID-19 was confirmed using real-time polymerase chain reaction testing and computed tomography scan findings. Data analysis was performed using SPSS software, version 20. P-value less than 0.05 was considered significant. Sixty-six cancer patients with COVID-19 were enrolled in this study. Among participants, 35 (53.03%) patients discharged and 31 (46.97%) patients died in hospital. Thirty-two (48.4%) patients suffered from hematologic and 34 (51.6%) from non-hematologic cancers. The most common comorbidities were hypertension (68.18%) and diabetes (56.06%). The most common symptoms among patients were rhinorrhea (59.1%), fever (54.5%) and dyspnea (48.4%), respectively. Diabetes (p= 0.00), hypoxemia (p= 0.005) and receiving chemotherapy or radiotherapy during the last three months (p= 0.022) were associated with a significantly greater risk of in-hospital mortality. Hypoxemia, diabetes and the time interval between chemotherapy/radiotherapy and hospitalization is associated with a higher risk of in-hospital mortality among cancer patients with COVID-19. These risk factors should be considered in clinical management hospitalized COVID19 patients who suffer from cancers. Regarding the risk factors may help to reduce in-hospital mortality and poor outcomes.