Clinical characteristics and outcomes in a cohort of oncologic patients with COVID‐19 during the first year of the pandemic in Mexico

Abstract

Background Literature on severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in cancer patients is scarce in Latin America. This population seems to have a higher risk for adverse outcomes. This study aims to correlate clinical characteristics with outcomes in patients with cancer. Methods We included all patients with cancer and confirmed SARS‐CoV‐2 infection from April 19 to December 31, 2020, at the Instituto Nacional de Cancerologia, Mexico. Clinical information was obtained from medical and epidemiological records. For the association between variables and hospitalization, invasive mechanical ventilation (IMV), and mortality, univariate and multivariate logistic regression were performed; odds ratios and 95% confidence intervals were calculated. Results Four hundred thirty‐three patients were included; 268 (62%) were female, the median age was 55 years. One hundred thirty‐five (31%), 131 (30%), and 93 (21%) patients had obesity, hypertension, and diabetes mellitus (DM), respectively. Three hundred forty‐one (79%) had solid cancer. One hundred seventy (39%) had advanced cancer. Two hundred (46%) patients were hospitalized. Age ( p < 0.01), male gender ( p = 0.03), hematological malignancies (HM) ( p = 0.04) and advanced cancer ( p = 0.03) increased the risk for hospital admission. Forty‐five (10%) patients required IMV. Age ( p = 0.02); DM ( p = 0.04); high C‐reactive protein ( p < 0.01), and lactate dehydrogenase ( p = 0.03) were associated with IMV. Mortality within 30 days after diagnosis was 18% (76 cases). Associated characteristics were age ( p = 0.04) and low albumin ( p < 0.01). Conclusions In this study, patients with cancer showed higher mortality, need for hospitalization, and IMV compared with other non‐cancer cohorts. We did not find an increased risk in mortality for HM. Although our cohort was younger than others previously reported, age was a strong predictor of adverse outcomes. Variables associated with IMV and death were similar to those previously described in cancer patients with COVID‐19.

Survival of Patients with Hematologic Malignancies and Covid-19

“…Another study conducted in the Mexican population, which included four hundred thirty-three patients with solid tumors (79%), hematological neoplasms (21%) and COVID19 from the National Cancer Institute of Mexico, reported one hundred thirty-five (31%), 131 (30%), and 93 (21%) patients had obesity, hypertension, and diabetes mellitus (DM), respectively and a mortality within 30 days after diagnosis of 18% [12].…”

Use of remdesivir for COVID-19 in patients with hematologic cancer

“…An Israeli study reported a mortality rate of 20% in hematologic patients, before the Delta wave [ 25 ]. At INCan, we reported a cohort of non-vaccinated patients with Cancer and COVID-19, with a mortality rate of 18% [ 26 ]. Regarding Omicron, Taenaka et al reported an outbreak of 9 patients with HM in February 2022, with a mortality rate of 22% [ 13 ].…”

Mortality of COVID-19 in Patients with Hematological Malignancies Versus Solid Tumors: A Systematic Literature Review and Meta-Analysis

“…Fu et al performed a multicenter retrospective chart review that included 233 COVID-19 patients with active cancer (Hem: n = 69, Tumor: n = 164). From a multivariable logistic regression adjusted for age, sex, race, obesity, D-dimer levels, and cancer treatment (no treatment vs. chemotherapy treatment in the past 3 months vs. other treatment), there was no statistically significant difference in odds of mortality between patients with hematological malignancies and solid tumors, although the directionality of the effect estimate favored patients with solid tumors (OR = 1.82 [95% CI: 0.88-3.77], p = 0.11) [29]. This study was deemed to be associated with a moderate risk of bias.…”

“…Twenty-one studies reported data on all-cause mortality [14,[24][25][26][27][28][29][30][31][32][33][34][35][36][39][40][41][42][43][44][45]. Of these, 4 studies were associated with a low risk of bias, 4 were associated with a moderate risk of bias, and 13 were associated with a high risk of bias.…”