Outcome of oncological patients admitted with COVID-19: experience of a hospital center in northern Italy

Abstract

Background: Recent literature regarding the outcome of cancer patients infected with COVID-19 are not encouraging. Nevertheless, current evidence on the risk and benefits of continuing oncological treatment of cancer patients during the pandemic remains insufficient. We provide our experience in a center with high access for patients with COVID-19-associated pneumonia in Lombardy, Italy. We conducted a retrospective study using a prospectively maintained database of patients admitted to our hospital between 25 February 2020 and 9 April 2020 with a confirmed diagnosis of COVID-19 pneumonia. Results: A total of 53 patients with a history or current oncological disease were included in this study. Sixteen oncological patients (30.2%) died during hospitalization. Multivariable logistic regression analysis found that age (Odds ratio [OR]: 1.17, p = 0.009), diabetes (OR: 15.05, p = 0.028) and active oncological disease (OR 13.60, p = 0.015) were independently associated with in-hospital mortality. The mortality rate of the total number of cancer patients is about twice as high as that of non-oncological patients admitted to our hospital with a diagnosis of COVID-19. Conclusion: The presence of active oncological disease is independently related to mortality as well as age and diabetes. The majority of patients who died were frail. Careful evaluation of the risks and benefits of treatment in frail patients is needed, considering that difficult access to intensive care may have affected the mortality rate.

A meta-analysis on the risk factors adjusted association between cardiovascular disease and COVID-19 severity

“…pre-COVID ICU beds), regional density of COVID-19 (quartiles) 7 Raparelli et al (2021) [ 112 ] Italy 3517 77.64±11.51 2346 (66.7) Retrospective analysis Congestive Heart Failure 539 (15.7) OR 0.75 (0.56-1.00) Death AGE, IHD, T2DM, dementia, COPD, CLD, CKD, AD, fever, SOB, cough, admission in ICU, AKI, acute cardiac injury, shock, antivirals, tocilizumab, length of stay 6 Chinnadurai et al (2020) [ 113 ] UK 215 74 (60–82) 133 (61.9) Single-center observational study CVD 93 (43.3) OR 1.20 (0.61–2.40) Mortality Age, care home resident, frailty, smoking, respiratory diseases 6 Rajter et al (2020) [ 114 ] USA 280 59.6±15.9 153 (64.6) NR Cardiac Disease 43 (15.4) OR 1.51 (0.43-5.22) Mortality Treatment group (Ivermectin VS Control), age, gender, current or former smoker, Race (Black, Hispanic, Other, White), comorbidities (diabetes, pulmonary, HTBN, No comorbidities), BMI, severe presentation, Intubated at study entry, MAP < 70 mm Hg, corticosteroid treatment, peripheral white cell count, lymphocyte count 7 Naaraayan ey al. (2020) [ 115 ] USA 362 71 (59–82) 200 (55.3) Retrospective case series Cardiac diseases 119 (32.9) OR 0.9 (0.5–1.4) In-hospital mortality age, sex, hypertension, diabetes, race, chronic obstructive pulmonary disease, renal disease and obesity 6 Cherri et al (2020) [ 116 ] Italy 53 75 (68–83) 32 (60.4) Retrospective study Cardiopathy 20 (37.7) OR 1.15 (0.187-7.13) Mortality Age, BMI, diabetes, active oncological disease 7 Rodríguez-Molinero et al (2020) [ 117 ] Spai...…”