Impact of solid cancer on in-hospital mortality overall and among different subgroups of patients with COVID-19: a nationwide, population-based analysis

Abstract

BackgroundCancer seems to have an independent adverse prognostic effect on COVID-19-related mortality, but uncertainty exists regarding its effect across different patient subgroups. We report a population-based analysis of patients hospitalised with COVID-19 with prior or current solid cancer versus those without cancer.MethodsWe analysed data of adult patients registered until 24 May 2020 in the Belgian nationwide database of Sciensano. The primary objective was in-hospital mortality within 30 days of COVID-19 diagnosis among patients with solid cancer versus patients without cancer. Severe event occurrence, a composite of intensive care unit admission, invasive ventilation and/or death, was a secondary objective. These endpoints were analysed across different patient subgroups. Multivariable logistic regression models were used to analyse the association between cancer and clinical characteristics (baseline analysis) and the effect of cancer on in-hospital mortality and on severe event occurrence, adjusting for clinical characteristics (in-hospital analysis).ResultsA total of 13 594 patients (of whom 1187 with solid cancer (8.7%)) were evaluable for the baseline analysis and 10 486 (892 with solid cancer (8.5%)) for the in-hospital analysis. Patients with cancer were older and presented with less symptoms/signs and lung imaging alterations. The 30-day in-hospital mortality was higher in patients with solid cancer compared with patients without cancer (31.7% vs 20.0%, respectively; adjusted OR (aOR) 1.34; 95% CI 1.13 to 1.58). The aOR was 3.84 (95% CI 1.94 to 7.59) among younger patients (<60 years) and 2.27 (95% CI 1.41 to 3.64) among patients without other comorbidities. Severe event occurrence was similar in both groups (36.7% vs 28.8%; aOR 1.10; 95% CI 0.95 to 1.29).ConclusionsThis population-based analysis demonstrates that solid cancer is an independent adverse prognostic factor for in-hospital mortality among patients with COVID-19. This adverse effect was more pronounced among younger patients and those without other comorbidities. Patients with solid cancer should be prioritised in vaccination campaigns and in tailored containment measurements.

Knowledge, attitudes and practices related to the COVID-19 outbreak among Romanian adults with cancer: a cross-sectional national survey

“… 5 , 6 , 7 , 8 In a recent nationwide, population-based analysis in Belgium, it has been shown that solid cancer is an independent adverse prognostic factor for in-hospital mortality among patients with COVID-19. 9 Consequently, international and national guidelines from various oncological societies and hospitals have been developed to reduce the exposure of cancer patients to SARS-CoV-2 infection and diminish the impact of the pandemic upon health services for oncological diseases. 10 …”

Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians

“…Patients with cancer are at significantly increased risk of morbidity and death from COVID-19, with mortality estimates ranging from 11% to 40.5% across different studies. [1][2][3][4][5][6] This large range likely reflects the heterogeneity of these studies, with some including patients with inactive cancer versus only active cancer and some including only hospitalised patients. Although it is clear that COVID-19-related outcomes are poor in patients with cancer, the impact of anticancer therapy on these outcomes remains contentious.…”

Updated general recommendations in cancer management during the COVID-19 pandemic in the Philippines

“…Multiple studies carried out around the world have shown that patients with cancer are at a higher risk for severe complications and mortality from SARS-CoV-2 infection [13][14][15][16][17][18][19]. In the scientific brief by the World Health Organisation (WHO) on July 11, 2020, the organisation acknowledged the possibility of airborne transmission in addition to the droplet, contact, fomite, faecal-oral, bloodborne, mother-to-child and animal-to-human transmission.…”