Clinical characteristics and risk factors for mortality in cancer patients with COVID-19

Patients with cancer are at increased risk of severe infections. From a cohort including 3060 patients with confirmed COVID-19, 109(3.4%) cancer patients were included in this study. Among them, 23(21.1%)patients died in the hospital. Cancer patients, especially those with hematological malignancies(41.6%), urinary carcinoma(35.7%), malignancies of the digestive system(33.3%), gynecological malignancies(20%), and lung cancer(14.3%), had a much higher mortality than patients without cancer. A total of 19(17.4%) cancer patients were infected in the hospital. The clinical characteristics of deceased cancer patients were compared with those of recovered cancer patients. Multivariate Cox regression analysis indicated that a Nutritional Risk Screening(NRS2002) score ≥ 3(adjusted hazard ratio(HR) 11.00; 95% confidence interval(CI) 4.60–26.32; P < 0.001),high-risk type(adjusted HR 18.81; 95% CI 4.21–83.93; P < 0.001), tumor stage IV(adjusted HR 4.26; 95% CI2.34–7.75; P < 0.001), and recent adjuvant therapy(< 1 month)(adjusted HR 3.16; 95% CI 1.75–5.70; P < 0.01)were independent risk factors for in-hospital death after adjusting for age, comorbidities, D-dimer, and lymphocyte count. In conclusion, cancer patients showed a higher risk of COVID-19 infection with a poorer prognosis than patients without cancer. Cancer patients with high-risk tumor, NRS2002 score ≥ 3, advanced tumor stage, and recent adjuvant therapy(< 1 month) may have high risk of mortality.