학술논문
Clinical Characteristics, Care Trajectories and Mortality Rate of SARS-CoV-2 Infected Cancer Patients: A Multicenter Cohort Study
Document Type
article
Author
Marc-Antoine Benderra; Ainhoa Aparicio; Judith Leblanc; Demian Wassermann; Emmanuelle Kempf; Gilles Galula; Mélodie Bernaux; Anthony Canellas; Thomas Moreau; Ali Bellamine; Jean-Philippe Spano; Christel Daniel; Julien Champ; Florence Canouï-Poitrine; Joseph Gligorov; on Behalf of the AP-HP/Universities/INSERM COVID-19 Research Collaboration; Cancer AP-HP Group COVID-19 Task Force; AP-HP Covid CDW Initiative (ACCI)
Source
Cancers, Vol 13, Iss 19, p 4749 (2021)
Subject
Language
English
ISSN
2072-6694
Abstract
Background: COVID-19 may be more frequent and more severe in cancer patients than in other individuals. Our aims were to assess the rate of COVID-19 in hospitalized cancer patients, to describe their demographic characteristics, clinical features and care trajectories, and to assess the mortality rate. Methods: This multicenter cohort study was based on the Electronic Health Records of the Assistance Publique-Hôpitaux de Paris (AP-HP). Cancer patients with a diagnosis of COVID-19 between 3 March and 19 May 2020 were included. Main outcome was all-cause mortality within 30 days of COVID-19 diagnosis. Results: A total of 29,141 cancer patients were identified and 7791 (27%) were tested for SARS-CoV-2. Of these, 1359 (17%) were COVID-19-positive and 1148 (84%) were hospitalized; 217 (19%) were admitted to an intensive care unit. The mortality rate was 33% (383 deaths). In multivariate analysis, mortality-related factors were male sex (aHR = 1.39 [95% CI: 1.07–1.81]), advanced age (78–86 y: aHR = 2.83 [95% CI: 1.78–4.51] vs. 20 ng/mL (aHR = 2.20 [95% CI: 1.70–2.86]). Primary brains tumors (aHR = 2.19 [95% CI: 1.08–4.44]) and lung cancer (aHR = 1.66 [95% CI: 1.02–2.70]) were associated with higher mortality. Risk of dying was lower among patients with metabolic comorbidities (aHR = 0.65 [95% CI: 0.50–0.84]). Conclusions: In a hospital-based setting, cancer patients with COVID-19 had a high mortality rate. This mortality was mainly driven by age, sex, number of comorbidities and presence of inflammation. This is the first cohort of cancer patients in which metabolic comorbidities were associated with a better outcome.