Risk of COVID-19 death in cancer patients: an analysis from Guy's Cancer Centre and King's College Hospital in London

Br J Cancer. 2021 Sep;125(7):939-947. doi: 10.1038/s41416-021-01500-z. Epub 2021 Aug 16.

Abstract

Background: Using an updated dataset with more patients and extended follow-up, we further established cancer patient characteristics associated with COVID-19 death.

Methods: Data on all cancer patients with a positive reverse transcription-polymerase chain reaction swab for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) at Guy's Cancer Centre and King's College Hospital between 29 February and 31 July 2020 was used. Cox proportional hazards regression was performed to identify which factors were associated with COVID-19 mortality.

Results: Three hundred and six SARS-CoV-2-positive cancer patients were included. Seventy-one had mild/moderate and 29% had severe COVID-19. Seventy-two patients died of COVID-19 (24%), of whom 35 died <7 days. Male sex [hazard ratio (HR): 1.97 (95% confidence interval (CI): 1.15-3.38)], Asian ethnicity [3.42 (1. 59-7.35)], haematological cancer [2.03 (1.16-3.56)] and a cancer diagnosis for >2-5 years [2.81 (1.41-5.59)] or ≥5 years were associated with an increased mortality. Age >60 years and raised C-reactive protein (CRP) were also associated with COVID-19 death. Haematological cancer, a longer-established cancer diagnosis, dyspnoea at diagnosis and raised CRP were indicative of early COVID-19-related death in cancer patients (<7 days from diagnosis).

Conclusions: Findings further substantiate evidence for increased risk of COVID-19 mortality for male and Asian cancer patients, and those with haematological malignancies or a cancer diagnosis >2 years. These factors should be accounted for when making clinical decisions for cancer patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / complications
  • COVID-19 / epidemiology*
  • COVID-19 / pathology
  • COVID-19 / virology
  • Female
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / epidemiology*
  • Hematologic Neoplasms / pathology
  • Hematologic Neoplasms / virology
  • Hospitals
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / epidemiology*
  • Neoplasms / pathology
  • Neoplasms / virology
  • Risk Factors
  • SARS-CoV-2 / pathogenicity*