COVID-19 mortality in cancer patients: a report from a tertiary cancer centre in India

Anurag Mehta; Smreti Vasudevan; Anuj Parkash; Anurag Sharma; Tanu Vashist; Vidya Krishna

doi:10.7717/peerj.10599

COVID-19 mortality in cancer patients: a report from a tertiary cancer centre in India

PeerJ. 2021 Jan 21:9:e10599. doi: 10.7717/peerj.10599. eCollection 2021.

Authors

Anurag Mehta¹, Smreti Vasudevan², Anuj Parkash³, Anurag Sharma², Tanu Vashist², Vidya Krishna²

Affiliations

¹ Department of Laboratory, Transfusion and Molecular Diagnostics Services, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, Delhi, India.
² Department of Research, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, Delhi, India.
³ Department of Laboratory and Transfusion Services, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, Delhi, India.

Abstract

Background: Cancer patients, especially those receiving cytotoxic therapy, are assumed to have a higher probability of death from COVID-19. We have conducted this study to identify the Case Fatality Rate (CFR) in cancer patients with COVID-19 and have explored the relationship of various clinical factors to mortality in our patient cohort.

Methods: All confirmed cancer cases presented to the hospital from June 8 to August 20, 2020, and developed symptoms/radiological features suspicious of COVID-19 were tested by Real-time polymerase chain reaction assay and/or cartridge-based nucleic acid amplification test from a combination of naso-oropharyngeal swab for SARS-CoV-2. Clinical data, treatment details, and outcomes were assessed from the medical records.

Results: Of the total 3,101 cancer patients admitted to the hospital, 1,088 patients were tested and 186 patients were positive for SARS-CoV-2. The CFR in the cohort was 27/186 (14.52%). Univariate analysis showed that the risk of death was significantly associated with the presence of any comorbidity (OR: 2.68; (95% CI [1.13-6.32]); P = 0.025), multiple comorbidities (OR: 3.01; (95% CI [1.02-9.07]); P = 0.047 for multiple vs. single), and the severity of COVID-19 presentation (OR: 27.48; (95% CI [5.34-141.49]); P < 0.001 for severe vs. not severe symptoms). Among all comorbidities, diabetes (OR: 3.31; (95% CI [1.35-8.09]); P = 0.009) and cardiovascular diseases (OR: 3.77; (95% CI [1.02-13.91]); P = 0.046) were significant risk factors for death. Anticancer treatments including chemotherapy, surgery, radiotherapy, targeted therapy, and immunotherapy administered within a month before the onset of COVID-19 symptoms had no significant effect on mortality.

Conclusion: To the best of our knowledge, this is the first study from India reporting the CFR, clinical associations, and risk factors for mortality in SARS-CoV-2 infected cancer patients. Our study shows that the frequency of COVID-19 in cancer patients is high. Recent anticancer therapies are not associated with mortality. Pre-existing comorbidities, especially diabetes, multiple comorbidities, and severe symptoms at presentation are significantly linked with COVID-19 related death in the cohort.

Keywords: Cancer; Case fatality rate; Comorbidities; SARS-CoV-2.

Grants and funding

The authors received no funding for this work.