Differences in mortality of cancer patients with COVID-19 in a Brazilian cancer center

Abstract

Introduction To analyze COVID-19 mortality in cancer patients and associated factors such as age, sex, type of insurance, situation at COVID-19 diagnosis, and cancer histology during the pandemic at a cancer center in Brazil. Methods Cross-sectional study carried out from April 02, 2020 to August 31, 2020 at A.C. Camargo Cancer Center (ACCCC), in São Paulo, Brazil. Cases were extracted from the Hospital Cancer Registry. COVID-19 lethality rates by histology were calculated; multiple logistic regression was used to identify factors associated with COVID-19 mortality. The log-rank test was applied to compare the survival curves for each variable. Results Of the 411 patients analyzed, 51 (12.4%) died due to COVID-19. Death occurred at an average age of 63 years. The fatality rate was higher for lung (0.333) and hematological (0.213) cancers and was associated with age over 60 years. The greatest chances of death from COVID-19 were in cases of lung (odds ratio, OR, 4.05, 95% confidence interval, CI 1.33–12.34) and hematological (OR 2.17, 95% CI 0.96–4.90) cancers, and in patients currently undergoing cancer treatment (OR 2.77, 95% CI 1.25–6.13). There were no statistical differences in survival by sex, age group, type of insurance, situation at the diagnosis of COVID-19, and histology of cancer for COVID-19. Conclusions Mortality due to COVID-19 in cancer patients is heterogeneous. These findings reinforce the need for individualized strategies for the management of different types of cancer that reduce the risk of death from COVID-19.

Higher severity and risk of in‐hospital mortality for COVID‐19 patients with cancer during the year 2020 in Brazil: A countrywide analysis of secondary data

“…28 In a Brazilian study, patients with lung or hematological cancer and patients under oncological treatment had a higher risk of death among patients with COVID-19. 14 Mortality due to COVID-19 in patients with cancer could be heterogeneous for different kinds of primary tumors, and individualized strategies for preventing or reducing the risk of mortality in COVID-19 patients with cancer are necessary.…”

“…8 They are often older, immunosuppressed, and poorly nourished and have different comorbidities and adverse effects caused by oncological treatment. 5,7,8,14 Hematological malignancies, associated with greater susceptibility due to immune system impairment, have been associated with a poor prognosis for COVID-19 patients with cancer. 8,14,28 Oncological treatments have also been related to the risk of mortality due to COVID-19.…”

“…9 In a pioneering Brazilian study, COVID-19 patients with lung and hematological cancers were found to have a greater risk of death when they were undergoing oncological treatment. 14 However, these studies failed to determine the risk of mortality in COVID-19 patients with cancer according to gender and in different topographies. Recently, 2 other Brazilian studies using a large nationwide surveillance database showed higher in-hospital mortality for COVID-19 patients who were from the northern and northeastern regions of the country, who were brown-and black-skinned, 15 who Cancer November 15, 2021 were older, and who were admitted to the intensive care unit (ICU).…”

Lessons Learned in Managing Patients with Colorectal Cancer During the COVID-19 Pandemic

“…A systematic review and pooled analysis of over 18,650 cancer patients with COVID-19 from 52 international studies reported a 25.6% mortality rate [14•]. Other individual and pooled studies report mortality rates between 12 and 30% and suggest that a cancer diagnosis is associated with worse COVID-19 outcomes [15][16][17][18][19][20][21]. In contrast, some studies report more comparable outcomes between cancer and non-cancer patients [22,23].…”

“…Other centers have also reported low rates of COVID-19 infection while on systemic therapy [24]. In contrast, some studies suggest that mortality is higher in patients having received active cancer treatment [17,25,26]. A large case-control study including over 73 million electronic medical records reported patients with cancer had significantly higher risks of COVID-19 infection and worse outcomes [21].…”