COVID-19 Presentation and Outcomes among Cancer Patients: A Matched Case-Control Study

SIMPLE SUMMARY: Cancer patients have been described in previous studies as having a higher risk of contracting COVID-19 and a higher risk of developing a severe form of the disease. In this study, we compared a group of patients hospitalized for COVID-19 within the Lyon area with a matched group of patients free of cancer and also hospitalized for COVID-19. Cancer patients and control patients were matched in order to have a similar age, gender, and other preexisting conditions. In this study, the risk of death was higher among cancer patients, but the intensity of care was lower (lower access to intensive care unit, shorter length of stay). The risk of death among cancer patients appears to be mainly driven by the severity of the infection and therapeutic limitations decided at admission. ABSTRACT: It has been suggested that cancer patients are at higher risk of contracting COVID-19 and at higher risk of developing a severe form of the disease and fatality. This study’s objectives were to measure the excess risk of mortality and morbidity of patients with cancer among patients hospitalized for a SARS-CoV-2 infection, and to identify factors associated with the risk of death and morbidity among cancer patients. All first cancer patients hospitalized for COVID-19 in the two main hospitals of the Lyon area were included. These patients were matched based on age, gender, and comorbidities with non-cancer control patients. A total of 108 cancer patients and 193 control patients were included. The severity at admission and the symptoms were similar between the two groups. The risk of early death was higher among cancer patients, while the risk of intubation, number of days with oxygen, length of stay in ICU, and length of hospital stay were reduced. The main factors associated with early death among cancer patients was the severity of COVID-19 and the number of previous chemotherapy lines. The outcomes appear to be driven by the severity of the infection and therapeutic limitations decided at admission.