1
|
Leston M, Elson W, Ordóñez-Mena JM, Kar D, Whitaker H, Joy M, Roberts N, Hobbs FDR, de Lusignan S. Disparities in COVID-19 mortality amongst the immunosuppressed: A systematic review and meta-analysis for enhanced disease surveillance. J Infect 2024; 88:106110. [PMID: 38302061 PMCID: PMC10943183 DOI: 10.1016/j.jinf.2024.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Effective disease surveillance, including that for COVID-19, is compromised without a standardised method for categorising the immunosuppressed as a clinical risk group. METHODS We conducted a systematic review and meta-analysis to evaluate whether excess COVID-associated mortality compared to the immunocompetent could meaningfully subdivide the immunosuppressed. Our study adhered to UK Immunisation against infectious disease (Green Book) criteria for defining and categorising immunosuppression. Using OVID (EMBASE, MEDLINE, Transplant Library, and Global Health), PubMed, and Google Scholar, we examined relevant literature between the entirety of 2020 and 2022. We selected for cohort studies that provided mortality data for immunosuppressed subgroups and immunocompetent comparators. Meta-analyses, grey literature and any original works that failed to provide comparator data or reported all-cause or paediatric outcomes were excluded. Odds Ratios (OR) and 95% confidence intervals (CI) of COVID-19 mortality were meta-analysed by immunosuppressed category and subcategory. Subgroup analyses differentiated estimates by effect measure, country income, study setting, level of adjustment, use of matching and publication year. Study screening, extraction and bias assessment were performed blinded and independently by two researchers; conflicts were resolved with the oversight of a third researcher. PROSPERO registration number is CRD42022360755. FINDINGS We identified 99 unique studies, incorporating data from 1,542,097 and 56,248,181 unique immunosuppressed and immunocompetent patients with COVID-19 infection, respectively. Compared to immunocompetent people (pooled OR, 95%CI), solid organ transplants (2.12, 1.50-2.99) and malignancy (2.02, 1.69-2.42) patients had a very high risk of COVID-19 mortality. Patients with rheumatological conditions (1.28, 1.13-1.45) and HIV (1.20, 1.05-1.36) had just slightly higher risks than the immunocompetent baseline. Case type, setting income and mortality data matching and adjustment were significant modifiers of excess immunosuppressed mortality for some immunosuppressed subgroups. INTERPRETATION Excess COVID-associated mortality among the immunosuppressed compared to the immunocompetent was seen to vary significantly across subgroups. This novel means of subdivision has prospective benefit for targeting patient triage, shielding and vaccination policies during periods of high disease transmission.
Collapse
Affiliation(s)
- Meredith Leston
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom.
| | - Willam Elson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Jose M Ordóñez-Mena
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Debasish Kar
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Heather Whitaker
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Old Campus Road, Old Campus Research Building, Headington, Oxford OX3 7DQ, United Kingdom
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| |
Collapse
|
2
|
Park JM, Koo HY, Lee JR, Lee H, Lee JY. COVID-19 Mortality and Severity in Cancer Patients and Cancer Survivors. J Korean Med Sci 2024; 39:e6. [PMID: 38225782 PMCID: PMC10789529 DOI: 10.3346/jkms.2024.39.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/26/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND We aimed to investigate mortality, severity, and risk of hospitalization in coronavirus disease 2019 (COVID-19) patients with cancer. METHODS Data of all patients aged 40-79 years from the Korean Disease Control and Prevention Agency-COVID19-National Health Insurance Service who were diagnosed with COVID-19 between January 1, 2020 and March 31, 2022, in Korea were included. After 1:1 propensity score matching, 397,050 patients with cancer and 397,050 patients without cancer were enrolled in the main analysis. A cancer survivor was defined as a patient who had survived 5 or more years since the diagnosis of cancer. Multiple logistic regression analysis was performed to compare the risk of COVID-19 according to the diagnosis of cancer and time since diagnosis. RESULTS Cancer, old age, male sex, incomplete vaccination against COVID-19, lower economic status, and a higher Charlson comorbidity index were associated with an increased risk of hospitalization, hospitalization with severe state, and death. Compared to patients without cancer, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for hospitalization, hospitalization with severe state, and death in patients with cancer were 1.09 (1.08-1.11), 1.17 (1.11-1.24), and 1.94 (1.84-2.05), respectively. Compared to patients without cancer, the ORs (95% CIs) for hospitalization in cancer survivors, patients with cancer diagnosed 2-5 years, 1-2 years, and < 1 year ago were 0.96 (0.94-0.98), 1.10 (1.07-1.13), 1.30 (1.25-1.34), and 1.82 (1.77-1.87), respectively; the ORs (95% CIs) for hospitalization for severe disease among these patients were 0.90 (0.85-0.97), 1.22 (1.12-1.32), 1.60 (1.43-1.79), and 2.29 (2.09-2.50), respectively. CONCLUSION The risks of death, severe state, and hospitalization due to COVID-19 were higher in patients with cancer than in those without; the more recent the diagnosis, the higher the aforementioned risks. Cancer survivors had a lower risk of hospitalization and hospitalization with severe disease than those without cancer.
Collapse
Affiliation(s)
- Jae-Min Park
- Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
- Department of Medicine, Graduate School of Medicine, Yonsei University, Seoul, Korea
| | - Hye Yeon Koo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Ryun Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.
| | - Jin Yong Lee
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Public Healthcare Center, Seoul National University Hospital, Seoul, Korea
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
| |
Collapse
|
3
|
Costa GJ, da Silva JR, da Silva CCA, de Lima TPF, Costa MM, Sousa MHO, Costa GCDS, Costa JI, Sales MJT. Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study. J Bras Pneumol 2023; 49:e20230145. [PMID: 37729337 PMCID: PMC10578947 DOI: 10.36416/1806-3756/e20230145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/05/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE To determine the clinical profile of COVID-19 inpatients who were vaccinated prior to hospitalization and to compare the risk factors for death and the 28-day survival rate of between those inpatients vaccinated with one, two, or three doses and unvaccinated COVID-19 inpatients. METHODS This was a retrospective observational cohort study involving COVID-19 patients admitted to a referral hospital in the city of Recife, Brazil, between July of 2020 and June of 2022. RESULTS The sample comprised 1,921 inpatients, 996 of whom (50.8%) were vaccinated prior to hospitalization. After adjusting the mortality risk for vaccinated patients, those undergoing invasive mechanical ventilation (IMV) had the highest mortality risk (adjusted OR [aOR] = 7.4; 95% CI, 3.8-14.1; p < 0.001), followed by patients > 80 years of age (aOR = 7.3; 95% CI, 3.4-15.4; p < 0.001), and those needing vasopressors (aOR = 5.6; 95% CI, 2.9-10.9; p < 0.001). After adjusting the mortality risk for all patients, having received three vaccine doses (aOR = 0.06; 95% CI, 0.03-0.11; p < 0.001) was the most important protective factor against death. There were progressive benefits of vaccination, reducing the frequency of ICU admissions, use for IMV, and death (respectively, from 44.9%, 39.0% and 39.9% after the first dose to 16.7%, 6.2% and 4.4% after the third dose), as well as significant improvements in survival after each subsequent dose (p < 0.001). CONCLUSIONS Vaccines were effective in reducing illness severity and death in this cohort of COVID-19 inpatients, and the administration of additional doses conferred them with accumulative vaccine protection.
Collapse
Affiliation(s)
| | - José Roberto da Silva
- . Departamento de Ensino e Pesquisa, Instituto de Medicina Integral Professor Fernando Figueira - IMIP - Recife (PE) Brasil
| | - Caio Cesar Arruda da Silva
- . Departamento de Ensino e Pesquisa, Instituto de Medicina Integral Professor Fernando Figueira - IMIP - Recife (PE) Brasil
| | | | - Mariana Menezes Costa
- . Departamento de Ensino e Pesquisa, Instituto de Medicina Integral Professor Fernando Figueira - IMIP - Recife (PE) Brasil
| | - Marcos Henrique Oliveira Sousa
- . Departamento de Ensino e Pesquisa, Instituto de Medicina Integral Professor Fernando Figueira - IMIP - Recife (PE) Brasil
| | | | - José Iran Costa
- . Departamento de Ensino e Pesquisa, Hospital Alfa, Recife (PE) Brasil
| | - Mozart Júlio Tabosa Sales
- . Departamento de Ensino e Pesquisa, Instituto de Medicina Integral Professor Fernando Figueira - IMIP - Recife (PE) Brasil
| |
Collapse
|
4
|
Quilan F, Lequesne J, Cherifi F, Bastien E, Morel A, Delcambre C, Da Silva A, Grellard J, Leconte A, Faveyrial A, Clarisse B, Joly F. Does COVID-19 pandemic impact cancer outcomes in metastatic setting? A comparative cohort study among metastatic patients treated at day care hospital. Cancer Med 2023; 12:17603-17612. [PMID: 37492987 PMCID: PMC10523941 DOI: 10.1002/cam4.6378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION COVID-19 outbreak rapidly spread since early 2020 leading to the implementation of nationwide lockdowns. To cope with this sudden change, management guidelines were quickly published to adapt oncological care, with potential impact on cancer outcomes. METHODS We conducted a retrospective comparative cohort study to assess the impact of the COVID-19 outbreak in 2020 on cancer outcomes in metastatic patients. Two cohorts of metastatic patients receiving intravenous (iv) therapy in a French oncological day care hospital were assessed: a 2020 cohort during the first French lockdown, and a 2018 historical cohort before the COVID-19 pandemic. We performed a propensity score analysis to match patients from the two cohorts. After one-year follow-up, we compared progression-free survival (PFS) and overall survival (OS) between cohorts. Adaptations of medical oncological treatments in 2020 were also analysed. RESULTS The 376 patients of the 2020 cohort were matched with 376 of the 2018 cohort. No SARS-CoV-2 infection was observed in the 2020 cohort. The adjusted PFS was significantly shorter in 2020 compared to 2018 (HR = 1.23; 95% CI: 1.03-1.46), as well as among patients without treatment adaptation compared to matched patients of the 2018 cohort (HR = 1.33; 95% CI: 1.10-1.61). We did not observe any significant difference of PFS among the group with treatment adaptations. OS was not significantly different. CONCLUSION Metastatic cancer patients treated during the first lockdown had a higher risk of disease progression 1 year after COVID-19 outbreak. However, oncological treatment adaptations or SARS-CoV-2 infections do not explain these results. A longer follow-up is needed to observe the impact on OS.
Collapse
Affiliation(s)
- Florian Quilan
- Medical Oncology DepartmentCentre François BaclesseCaenFrance
| | | | | | - Etienne Bastien
- Medical Oncology DepartmentCentre François BaclesseCaenFrance
| | - Adeline Morel
- Medical Oncology DepartmentCentre François BaclesseCaenFrance
| | | | | | | | | | | | | | - Florence Joly
- Medical Oncology DepartmentCentre François BaclesseCaenFrance
- Clinical Research DepartmentCentre François BaclesseCaenFrance
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086CaenFrance
| |
Collapse
|
5
|
Arayici ME, Kipcak N, Kayacik U, Kelbat C, Keskin D, Kilicarslan ME, Kilinc AV, Kirgoz S, Kirilmaz A, Kizilkaya MA, Kizmaz IG, Kocak EB, Kochan E, Kocpinar B, Kordon F, Kurt B, Ellidokuz H. Effects of SARS-CoV-2 infections in patients with cancer on mortality, ICU admission and incidence: a systematic review with meta-analysis involving 709,908 participants and 31,732 cancer patients. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04191-y. [PMID: 35831763 PMCID: PMC9281353 DOI: 10.1007/s00432-022-04191-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/06/2022] [Indexed: 12/24/2022]
Abstract
Background Cancer patients constitute one of the highest-risk patient groups during the COVID-19 pandemic. In this study, it was aimed to perform a systematic review and meta-analysis to determine both the incidence and ICU (Intensive Care Unit) admission rates and mortality in SARS-CoV-2 infected cancer patients. Methods The PRISMA guidelines were closely followed during the design, analysis, and reporting of this systematic review and meta-analysis. A comprehensive literature search was performed for the published papers in PubMed/Medline, Scopus, medRxiv, Embase, and Web of Science (WoS) databases. SARS-CoV-2 infection pooled incidence in the cancer populations and the risk ratio (RR) of ICU admission rates/mortality in cancer and non-cancer groups, with 95% confidence intervals (CIs), were calculated using the random-effects model. Results A total of 58 studies, involving 709,908 participants and 31,732 cancer patients, were included in this study. The incidence in cancer patients was calculated as 8% (95% CI: 8–9%). Analysis results showed that mortality and ICU admission rate was significantly higher in patients with cancer (RR = 2.26, 95% CI: 1.94–2.62, P < 0.001; RR = 1.45, 95% CI: 1.28–1.64, p < 0.001, respectively). Conclusion As a result, cancer was an important comorbidity and risk factor for all SARS-CoV-2 infected patients. This infection could result in severe and even fatal events in cancer patients. Cancer is associated with a poor prognosis in the COVID-19 pandemic. Cancer patients should be assessed more sensitively in the COVID-19 outbreak. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04191-y.
Collapse
Affiliation(s)
- Mehmet Emin Arayici
- Department of Preventive Oncology, Institute of Health Sciences, Dokuz Eylul University, 15 July Medicine and Art Campus, Inciralti-Balcova 35340, Izmir, Turkey
| | - Nazlican Kipcak
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ufuktan Kayacik
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Cansu Kelbat
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Deniz Keskin
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Ahmet Veli Kilinc
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Sumeyye Kirgoz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Anil Kirilmaz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Melih Alihan Kizilkaya
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Irem Gaye Kizmaz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Enes Berkin Kocak
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Enver Kochan
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Begum Kocpinar
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Fatmanur Kordon
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Batuhan Kurt
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hulya Ellidokuz
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Department of Preventive Oncology, Institute of Oncology, Dokuz Eylul University, Izmir, Turkey
| |
Collapse
|
6
|
Sena GR, Lima JTO, Lima TPF, Vidal SA, Sales MJT, Goes PSA, Mello MJG. Inequity in inequity: Disproportional mortality risk in patients with cancer with COVID-19 in Brazil - a call to action. J Geriatr Oncol 2022; 13:885-887. [PMID: 35654724 PMCID: PMC9110538 DOI: 10.1016/j.jgo.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/24/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Gabrielle R Sena
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil; Faculdade Pernambucana de Saúde, Pernambuco, Brazil.
| | - Jurema T O Lima
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil; Faculdade Pernambucana de Saúde, Pernambuco, Brazil
| | - Tiago P F Lima
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil; Instituto Federal de Pernambuco- IFPE, Pernambuco, Brazil
| | - Suely A Vidal
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil
| | - Mozart J T Sales
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil; Faculdade Pernambucana de Saúde, Pernambuco, Brazil
| | - Paulo S A Goes
- Universidade Federal de Pernambuco-UFPE, Pernambuco, Brazil; Faculdade de Medicina de Olinda-FMO, Pernambuco, Brazil
| | - Maria Julia G Mello
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil
| |
Collapse
|
7
|
Baptista JPR, Wozniaki N, Cassi Junior HV, Neves GD, Boettcher IS, Dall'Oglio AC, Tavares FS, Gastal GR, Schwingel FL, de Lacerda MP. Severity and One-Year Cumulative Incidence of COVID-19 Among Inpatients with Haematologic Malignancies. J Hosp Infect 2022; 126:125-127. [PMID: 35513183 PMCID: PMC9060715 DOI: 10.1016/j.jhin.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 11/05/2022]
Affiliation(s)
- João Pedro Ribeiro Baptista
- Universidade da Região de Joinville (UNIVILLE) - Rua Paulo Malschitzki, nº 10 Campus Universitário - Distrito Industrial, Joinville - SC, Brazil
| | - Natalia Wozniaki
- Universidade da Região de Joinville (UNIVILLE) - Rua Paulo Malschitzki, nº 10 Campus Universitário - Distrito Industrial, Joinville - SC, Brazil
| | - Helio Vida Cassi Junior
- Hospital Municipal São José (HMSJ) - Rua Dr. Plácido Gomes, 488 - Anita Garibaldi, Joinville - SC, Brazil
| | - Gabriela Duarte Neves
- Hospital Municipal São José (HMSJ) - Rua Dr. Plácido Gomes, 488 - Anita Garibaldi, Joinville - SC, Brazil
| | - Ivan Schneider Boettcher
- Hospital Municipal São José (HMSJ) - Rua Dr. Plácido Gomes, 488 - Anita Garibaldi, Joinville - SC, Brazil
| | - Ana Claudia Dall'Oglio
- Hospital Municipal São José (HMSJ) - Rua Dr. Plácido Gomes, 488 - Anita Garibaldi, Joinville - SC, Brazil
| | - Fabiana Sanchez Tavares
- Hospital Municipal São José (HMSJ) - Rua Dr. Plácido Gomes, 488 - Anita Garibaldi, Joinville - SC, Brazil
| | - Gabriela Roncone Gastal
- Hospital Municipal São José (HMSJ) - Rua Dr. Plácido Gomes, 488 - Anita Garibaldi, Joinville - SC, Brazil
| | - Fabiano Luis Schwingel
- Universidade da Região de Joinville (UNIVILLE) - Rua Paulo Malschitzki, nº 10 Campus Universitário - Distrito Industrial, Joinville - SC, Brazil; Hospital Municipal São José (HMSJ) - Rua Dr. Plácido Gomes, 488 - Anita Garibaldi, Joinville - SC, Brazil
| | - Marcelo Pitombeira de Lacerda
- Universidade da Região de Joinville (UNIVILLE) - Rua Paulo Malschitzki, nº 10 Campus Universitário - Distrito Industrial, Joinville - SC, Brazil; Hospital Municipal São José (HMSJ) - Rua Dr. Plácido Gomes, 488 - Anita Garibaldi, Joinville - SC, Brazil.
| |
Collapse
|
8
|
Costa GJ, de Azevedo CRAS, Júnior JIC, Bergmann A, Thuler LCS. Higher severity and risk of in-hospital mortality for COVID-19 patients with cancer during the year 2020 in Brazil: A countrywide analysis of secondary data. Cancer 2021; 127:4240-4248. [PMID: 34343344 PMCID: PMC8426714 DOI: 10.1002/cncr.33832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) and cancer are serious public health problems worldwide. However, little is known about the risk factors of in-hospital mortality among COVID-19 patients with and without cancer in Brazil. The objective of this study was to evaluate the risk factors of in-hospital mortality among COVID-19 patients with and without cancer and to compare mortality according to gender and topography during the year 2020 in Brazil. METHODS This was a secondary data study of hospitalized adult patients with a diagnosis of COVID-19 by real-time polymerase chain reaction testing in Brazil. The data were collected from the Influenza Epidemiological Surveillance Information System. RESULTS This study analyzed data from 322,817 patients. The prevalence of cancer in patients with COVID-19 was 2.3%. COVID-19 patients with neurological diseases and cancer had the most lethal comorbidities in both sexes. COVID-19 patients with cancer were more likely to be older (median age, 67 vs 62 years; P < .001), to have a longer hospital stay (13.1 vs 11.5 days; P < .001), to be admitted to the intensive care unit (45.3% vs 39.6%; P < .001), to receive more invasive mechanical ventilation (27.1% vs 21.9%), and to have a higher risk of death (adjusted odds ratio [aOR], 1.94; 95% confidence interval [CI], 1.83-2.06; P < .001) than those without cancer. Patients with hematological neoplasia (aOR, 2.85; 95% CI, 2.41-3.38; P < .001) had a higher risk of mortality than those with solid tumors (aOR, 1.83; 95% CI, 1.72-1.95; P < .001) in both sexes. CONCLUSIONS Brazilian COVID-19 patients with cancer have higher disease severity and a higher risk of mortality than those without cancer.
Collapse
Affiliation(s)
- Guilherme Jorge Costa
- Department of Teaching and Research, Pernambuco Cancer Hospital, Recife, Brazil.,Department of Pneumology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
| | | | - José Iran Costa Júnior
- Department of Oncology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.,Oncologia D'Or, Recife, Brazil
| | - Anke Bergmann
- Clinical Epidemiology Program, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | | |
Collapse
|