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Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis
BACKGROUND: Although research on the effects of comorbidities on coronavirus disease 2019 (COVID-19) patients is increasing, the risk of cancer history has not been evaluated for the mortality of patients with COVID-19. METHODS: In this retrospective study, we included 3232 patients with pathogen-co...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286218/ https://www.ncbi.nlm.nih.gov/pubmed/32522278 http://dx.doi.org/10.1186/s13045-020-00907-0 |
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author | Meng, Yifan Lu, Wanrong Guo, Ensong Liu, Jia Yang, Bin Wu, Ping Lin, Shitong Peng, Ting Fu, Yu Li, Fuxia Wang, Zizhuo Li, Yuan Xiao, Rourou Liu, Chen Huang, Yuhan Lu, Funian Wu, Xue You, Lixin Ma, Ding Sun, Chaoyang Wu, Peng Chen, Gang |
author_facet | Meng, Yifan Lu, Wanrong Guo, Ensong Liu, Jia Yang, Bin Wu, Ping Lin, Shitong Peng, Ting Fu, Yu Li, Fuxia Wang, Zizhuo Li, Yuan Xiao, Rourou Liu, Chen Huang, Yuhan Lu, Funian Wu, Xue You, Lixin Ma, Ding Sun, Chaoyang Wu, Peng Chen, Gang |
author_sort | Meng, Yifan |
collection | PubMed |
description | BACKGROUND: Although research on the effects of comorbidities on coronavirus disease 2019 (COVID-19) patients is increasing, the risk of cancer history has not been evaluated for the mortality of patients with COVID-19. METHODS: In this retrospective study, we included 3232 patients with pathogen-confirmed COVID-19 who were hospitalized between January 18th and March 27th, 2020, at Tongji Hospital in Wuhan, China. Propensity score matching was used to minimize selection bias. RESULTS: In total, 2665 patients with complete clinical outcomes were analyzed. The impacts of age, sex, and comorbidities were evaluated separately using binary logistic regression analysis. The results showed that age, sex, and cancer history are independent risk factors for mortality in hospitalized COVID-19 patients. COVID-19 patients with cancer exhibited a significant increase in mortality rate (29.4% vs. 10.2%, P < 0.0001). Furthermore, the clinical outcomes of patients with hematological malignancies were worse, with a mortality rate twice that of patients with solid tumors (50% vs. 26.1%). Importantly, cancer patients with complications had a significantly higher risk of poor outcomes. One hundred nine cancer patients were matched to noncancer controls in a 1:3 ratio by propensity score matching. After propensity score matching, the cancer patients still had a higher risk of mortality than the matched noncancer patients (odds ratio (OR) 2.98, 95% confidence interval (95% CI) 1.76–5.06). Additionally, elevations in ferritin, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, procalcitonin, prothrombin time, interleukin-2 (IL-2) receptor, and interleukin-6 (IL-6) were observed in cancer patients. CONCLUSIONS: We evaluated prognostic factors with epidemiological analysis and highlighted a higher risk of mortality for cancer patients with COVID-19. Importantly, cancer history was the only independent risk factor for COVID-19 among common comorbidities, while other comorbidities may act through other factors. Moreover, several laboratory parameters were significantly different between cancer patients and matched noncancer patients, which may indicate specific immune and inflammatory reactions in COVID-19 patients with cancer. |
format | Online Article Text |
id | pubmed-7286218 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72862182020-06-11 Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis Meng, Yifan Lu, Wanrong Guo, Ensong Liu, Jia Yang, Bin Wu, Ping Lin, Shitong Peng, Ting Fu, Yu Li, Fuxia Wang, Zizhuo Li, Yuan Xiao, Rourou Liu, Chen Huang, Yuhan Lu, Funian Wu, Xue You, Lixin Ma, Ding Sun, Chaoyang Wu, Peng Chen, Gang J Hematol Oncol Research BACKGROUND: Although research on the effects of comorbidities on coronavirus disease 2019 (COVID-19) patients is increasing, the risk of cancer history has not been evaluated for the mortality of patients with COVID-19. METHODS: In this retrospective study, we included 3232 patients with pathogen-confirmed COVID-19 who were hospitalized between January 18th and March 27th, 2020, at Tongji Hospital in Wuhan, China. Propensity score matching was used to minimize selection bias. RESULTS: In total, 2665 patients with complete clinical outcomes were analyzed. The impacts of age, sex, and comorbidities were evaluated separately using binary logistic regression analysis. The results showed that age, sex, and cancer history are independent risk factors for mortality in hospitalized COVID-19 patients. COVID-19 patients with cancer exhibited a significant increase in mortality rate (29.4% vs. 10.2%, P < 0.0001). Furthermore, the clinical outcomes of patients with hematological malignancies were worse, with a mortality rate twice that of patients with solid tumors (50% vs. 26.1%). Importantly, cancer patients with complications had a significantly higher risk of poor outcomes. One hundred nine cancer patients were matched to noncancer controls in a 1:3 ratio by propensity score matching. After propensity score matching, the cancer patients still had a higher risk of mortality than the matched noncancer patients (odds ratio (OR) 2.98, 95% confidence interval (95% CI) 1.76–5.06). Additionally, elevations in ferritin, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, procalcitonin, prothrombin time, interleukin-2 (IL-2) receptor, and interleukin-6 (IL-6) were observed in cancer patients. CONCLUSIONS: We evaluated prognostic factors with epidemiological analysis and highlighted a higher risk of mortality for cancer patients with COVID-19. Importantly, cancer history was the only independent risk factor for COVID-19 among common comorbidities, while other comorbidities may act through other factors. Moreover, several laboratory parameters were significantly different between cancer patients and matched noncancer patients, which may indicate specific immune and inflammatory reactions in COVID-19 patients with cancer. BioMed Central 2020-06-10 /pmc/articles/PMC7286218/ /pubmed/32522278 http://dx.doi.org/10.1186/s13045-020-00907-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Meng, Yifan Lu, Wanrong Guo, Ensong Liu, Jia Yang, Bin Wu, Ping Lin, Shitong Peng, Ting Fu, Yu Li, Fuxia Wang, Zizhuo Li, Yuan Xiao, Rourou Liu, Chen Huang, Yuhan Lu, Funian Wu, Xue You, Lixin Ma, Ding Sun, Chaoyang Wu, Peng Chen, Gang Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis |
title | Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis |
title_full | Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis |
title_fullStr | Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis |
title_full_unstemmed | Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis |
title_short | Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis |
title_sort | cancer history is an independent risk factor for mortality in hospitalized covid-19 patients: a propensity score-matched analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286218/ https://www.ncbi.nlm.nih.gov/pubmed/32522278 http://dx.doi.org/10.1186/s13045-020-00907-0 |
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