Factors Associated with Deaths in Hospitalized Cancer Patients and COVID-19 in an Amazon Region: a Cross-sectional Study with Data from Epidemiological Surveillance

Abstract

Background: The COVID-19 pandemic has already affected Brazil dramatically, but the northern region of the country has suffered greater impacts due to regional vulnerability factors.
 Objective: To describe the factors associated with deaths in hospitalized cancer patients and COVID-19 in the state of Pará, Brazil.
 Methods: Cross-sectional study with data from epidemiological surveillance of acute and severe respiratory syndromes of hospitalized cases notified from January 1, 2020, to December 31, 2020. Clinical and outcome variables, chi-square test, and Odds ratio were analyzed.
 Results: 164 cases, lethality represented 94 (57.32%). The mean overall age was 63 years, of survivors was 60 years and of deaths was 66 years. Advanced age was associated with deaths (p-0.039). Male gender was associated with deaths (65.96% - p- 0.006 - OR 2,438 - CI 1,291-4,604). Similarly, the signs and symptoms associated with death were dyspnea (80.85% - p- 0.028 - OR 2,203 - CI 1,080-4,491), respiratory distress (76.60% - p- 0.003 - OR 2,756 - CI 1,410-5,387), O2 saturation <95% represented almost four times to the chances of death (68.09% - p-<0.001 - OR 3,398 - CI 1,798-6,494). Comorbidities were not associated with deaths, however, Immunodeficiency/Immunodepression represented the most frequent in the cases (22.56%), followed by Chronic Cardiovascular Disease (21.95%) and Diabetes Mellitus (18.90%). ICU admission was associated with deaths with the highest odds ratio of the analysis almost five times (42.55% - p- <0.001 - OR 4,444 - CI 2,028-9,739).
 Conclusion: In this study, we showed that the lethality was higher than in other studies of hospitalized cancer patients with COVID-19, as well as higher than the overall lethality of COVID-19 among hospitalized patients. The factors associated with deaths are similar to those in the literature, except that immunodeficiency is a specific condition in cancer patients and is associated with an unfavorable outcome.