Cancer has an Independent Association with Death in Hospitalized Patients with COVID-19: A Single-center Study in Iran

Reza Ghalehtaki; Kasra Kolahdouzan; Saeed Rezaei; Farzaneh Bagheri; Fatemeh Jafari; Mohammadreza Chavoshi; Negin Mohammadi; Monireh Sadat Seyyedsalehi; Azin Nahvijou; Nima  Mousavi Darzikolaee; Samaneh Salarvand; Ali Kazemian; Mahdi Aghili; Kazem Zendehdel

doi:10.18502/bccr.v13i1.8830

Reza Ghalehtaki Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
Kasra Kolahdouzan Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
Saeed Rezaei Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
Farzaneh Bagheri Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
Fatemeh Jafari Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
Mohammadreza Chavoshi Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Negin Mohammadi Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Monireh Sadat Seyyedsalehi Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
Azin Nahvijou Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
Nima Mousavi Darzikolaee Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
Samaneh Salarvand Department of Anatomical and Clinical Pathology, Tehran University of Medical Sciences, Tehran, Iran
Ali Kazemian Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
Mahdi Aghili Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
Kazem Zendehdel Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/bccr.v13i1.8830

Keywords: Cancer, Chemotherapy, COVID-19, Epidemic, Iran, SARS-CoV-2

Abstract

Background: COVID-19 could cause severe complications in those with pre-existing conditions such as cancer. Here, we aimed to assess the outcome of COVID-19 in hospitalized patients with a history of cancer.

Methods: In this retrospective cohort study, we extracted medical records of patients with any cancer history among hospitalized patients with COVID-19. Our patients were admitted between February 20th and July 15th, 2020. The primary outcome was death, and the secondary outcomes were overall survival, COVID-19-specific mortality, admission to intensive care unit (ICU), and hospital stay. A group of individuals without cancer history was selected from the COVID-19 cohort and matched for age, gender, and pre-existing conditions. We utilized univariate and multivariate logistic regression to analyze the association between studied variables and primary outcomes.

Results: We identified 46 patients with cancer and COVID-19. The median age was 63, and 54.3% were male. According to the univariate logistic regression analysis, death was 5.3 (CI95%: 1.75-15.85) times more probable in cancer patients than controls (p=0.003). The multivariate analysis adjusted for having cancer and sex, age, and having any comorbidity showing this figure was 5.5 (CI95%:1.8-16.8) (p=0.003). The 30- and 90-day COVID-19 specific mortality was 30% (CI95%:17-43) and 33% (CI95%: 20-46), respectively.

Conclusion: Patients with COVID-19 with a history of cancer have a considerably higher risk of death irrespective of age, gender, and other pre-existing conditions. Patients with advanced cancers and concurrent bacterial infections need the most vigorous care.