The rate of seroconversion 15 days after documented SARS-COV2 on RT-PCR was therefore significantly lower in cancer patients versus HCWs (30% versus 71%, P ¼ 0.04). Importantly, six of the seven serodiagnostic-negative cancer patients had received cytotoxic therapy or major surgical intervention in the previous 4 weeks, compared with none of the five remaining patients (P ¼ 0.003). None of these patients died.In this series, 5 of 85 (5.9%) and 13 of 244 (5.4%) cancer patients and HCWs, respectively, had detectable Ab against COVID-19. However, cancer patients had a significantly lower detection rate of SARS-COV2 Ab 15 days or later after symptoms and RT-PCRþ testing. Anti-SARS-COV2 Ab were more often undetectable in patients receiving cancer treatments in the month before testing. Additional studies will be needed to confirm whether immune response to the virus is influenced by recent cancer treatments.

BACKGROUND: New York City emerged as an epicenter of the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To describe the clinical characteristics and risk factors associated with mortality in a large patient population in the USA. DESIGN: Retrospective cohort study. PARTICIPANTS: 6493 patients who had laboratoryconfirmed COVID-19 with clinical outcomes between March 13 and April 17, 2020, who were seen in one of the 8 hospitals and/or over 400 ambulatory practices in the New York City metropolitan area MAIN MEASURES: Clinical characteristics and risk factors associated with in-hospital mortality. KEY RESULTS: A total of 858 of 6493 (13.2%) patients in our total cohort died: 52/2785 (1.9%) ambulatory patients and 806/3708 (21.7%) hospitalized patients. Cox proportional hazard regression modeling showed an increased risk of in-hospital mortality associated with age older than 50 years (hazard ratio [HR] 2.34, CI 1.47-3.71), systolic blood pressure less than 90 mmHg (HR 1.38, CI 1.06-1.80), a respiratory rate greater than 24 per min (HR 1.43, CI 1.13-1.83), peripheral oxygen saturation less than 92% (HR 2.12, CI 1.56-2.88), estimated glomerular filtration rate less than 60 mL/min/1.73m 2 (HR 1.80, CI 1.60-2.02), IL-6 greater than 100 pg/mL (HR 1.50, CI 1.12-2.03), D-dimer greater than 2 mcg/mL (HR 1.19, CI 1.02-1.39), and troponin greater than 0.03 ng/mL (HR 1.40, CI 1.23-1.62). Decreased risk of in-hospital mortality was associated with female sex (HR 0.84, CI 0.77-0.90), African American race (HR 0.78 CI 0.65-0.95), and hydroxychloroquine use (HR 0.53, CI 0.41-0.67). CONCLUSIONS: Among patients with COVID-19, older age, male sex, hypotension, tachypnea, hypoxia, impaired renal function, elevated D-dimer, and elevated troponin were associated with increased in-hospital mortality and hydroxychloroquine use was associated with decreased in-hospital mortality.

Highlights Fever was associated with poor outcomes in patients with COVID-19. Leukocytosis was associated with severe disease. Leukopenia was associated with a better prognosis. CRP was associated with poor prognosis. Leuocytosis and CRP on arrival may predict severe COVID-19.