Mortality in cancer patients with SARS-CoV-2 or seasonal influenza: an observational cohort study from a German-wide hospital network

Abstract

Purpose At the beginning of the COVID-19 pandemic, SARS-CoV-2 was often compared to seasonal influenza. We aimed to compare the outcome of hospitalized patients with cancer infected by SARS-CoV-2 or seasonal influenza including intensive care unit admission, mechanical ventilation and in-hospital mortality. Methods We analyzed claims data of patients with a lab-confirmed SARS-CoV-2 or seasonal influenza infection admitted to one of 85 hospitals of a German-wide hospital network between January 2016 and August 2021. Results 29,284 patients with COVID-19 and 7442 patients with seasonal influenza were included. Of these, 360 patients with seasonal influenza and 1625 patients with COVID-19 had any kind of cancer. Cancer patients with COVID-19 were more likely to be admitted to the intensive care unit than cancer patients with seasonal influenza (29.4% vs 24.7%; OR 1.31, 95% CI 1.00–1.73 p < .05). No statistical significance was observed in the mechanical ventilation rate for cancer patients with COVID-19 compared to those with seasonal influenza (17.2% vs 13.6% OR 1.34, 95% CI 0.96–1.86 p = .09). 34.9% of cancer patients with COVID-19 and 17.9% with seasonal influenza died (OR 2.45, 95% CI 1.81–3.32 p < .01). Risk factors among cancer patients with COVID-19 or seasonal influenza for in-hospital mortality included the male gender, age, a higher Elixhauser comorbidity index and metastatic cancer. Conclusion Among cancer patients, SARS-CoV-2 was associated with a higher risk for in-hospital mortality than seasonal influenza. These findings underline the need of protective measurements to prevent an infection with either COVID-19 or seasonal influenza, especially in this high-risk population.

Comparison of clinical outcomes in hospitalized patients with COVID-19 or non-COVID-19 community-acquired pneumonia in a prospective observational cohort study

“…In line with our results, Cangemi et al found in a prospective cohort study that COVID-19 was associated with a five-fold increase in the in-hospital mortality rate compared to NC-CAP [6]. In a retrospective analysis of hospitalized patients with COVID-19 or Influenza A from a nation-wide hospital network in Germany, Kodde et al found that COVID-19 was associated with three-fold increased odds for in-hospital death than Influenza A patients [27]. Serrano Fernandez et al observed rates of in-hospital death and invasive MV twice as high in COVID-19 pneumonia than in bacteremic pneumococcal CAP [28].…”

Improving Influenza Vaccination Coverage in Patients with Cancer: A Position Paper from a Multidisciplinary Expert Group

“…Notably, fatality rates ranging from 5% to 33% have been reported for cancer and hemopoietic stem cell transplant (HSCT) recipients with influenza [31,[34][35][36]. Furthermore, influenza infection often delays the initiation of anticancer treatment or interrupts ongoing treatment, worsening the oncologic outcome [6].…”

Influenza A (H1N1) virus induced long‐term remission in a refractory acute myeloid leukaemia

“…While both influenza A and SARS‐CoV‐2 viral infections during anti‐cancer therapy have been linked to increased mortality, elevated hospitalization rates and treatment delays, 2,3 the potential for utilizing viruses as therapeutic agents is also being explored. The study by You et al provides the first clinical evidence of the anti‐tumour effect of Influenza A virus in a refractory AML patient, thereby furnishing unique insights into the potential therapeutic benefits of Influenza A virus infection for haematological malignancies.…”