Patients With a History of Cancer Are More Likely to Die from COVID-19

A history of cancer may increase the risk of mortality in patients with COVID-19, according to a study.

“The main finding of our study was the increased probability of death in COVID-19 patients with cancer history compared with non-cancerous group, and this effect remains significant after adjustment of confounders,” the study authors wrote.

The case-control study took place in a referral hospital between Feb. 25 and April 21. Patients with versus without a history of cancer were matched by age, gender, and underlying diseases (ischemic heart disease [IHD], diabetes mellitus [DM], and hypertension [HTN]).

Final analysis included 53 confirmed COVID-19 patients with a history of cancer and 106 confirmed COVID-19 patients without a history of cancer. Just under half of patients were older than 65 years (45%). The most common presenting symptoms were dyspnea (57.86%) and fever (52.83%). In the cancer group, a significant correlation was observed between dyspnea and increased mortality (P=0.013). The non-cancer group had a higher proportion of survivors than the cancer group (n=89 [84%] vs. n=26 [49%]). When analyzing the cancer group, patients with hematologic cancer had a significantly higher mortality rate compared to those with solid tumors (63% vs. 37%). On multivariate analysis, factors associated with increased mortality risk were history of cancer, impaired consciousness level, tachypnea, tachycardia, leukocytosis, and thrombocytopenia.

The study was published in Infectious Agents and Cancer.

“Our study revealed that COVID-19 patients with hematologic cancers had the highest risk of death, ICU admission and intubation that was consistent with other studies comparing patients with hematologic cancer with solid tumors,” the researchers wrote. They further added, “Many factors could attribute to the increased risk of death in the hematologic population. Lower neutrophil counts prone this population to many bacterial, viral, and fungal super-infections which expectantly rises the risk of further complication and mortality. Moreover, thrombocytopenia is associated with ICU admission, mechanical ventilation or death within the first 14 days of admission with an OR of 2.48, in similar COVID-19 reports,” and thrombocytopenia at the time of hospital admission is more common among patients with hematologic cancers.