1. One-Year and Consequences of COVID-19 in Cancer Patients: a Cohort Study
- Author
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Fen Ai, Meixia Lu, Hong Fan, Cao Peng, Kui Chen, Yuying Wen, Wendan Wang, Zhaoming Tang, Banghong Da, Shuang Wen, Yuxiong Weng, Xiaojun Feng, Chen Chai, Xiaoxiong Wu, Yunfeng Li, Jinnong Zhang, Lei Wang, Hongxiang Wang, Zehai Tang, Hongrong Zhang, Shoupeng Li, Wei Li, and Gang Cheng
- Subjects
Oncology ,medicine.medical_specialty ,Text mining ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Internal medicine ,medicine ,Cancer ,business ,medicine.disease ,Cohort study - Abstract
Background The study aim was to investigate one-year all-cause mortality and health consequences of cancer COVID-19 patients in China, stratified by primary tumor subtype. Methods In this multicenter cohort study, 166 cancer COVID-19 patients were studied along with 498 gender- and age-matched non-cancer COVID-19 patients in four hospitals in Wuhan, China, admitted 2020/01/01-2020/03/18, as well as with 498 parallel gender-, age-, and cancer subtype- matched non-COVID cancer patients hospitalized between 2019/01/01-2020/03/17. All patients were followed-up with a telephone survey to assess health consequences. Cox proportional hazards regression were used for risk analysis. Results In the three cohorts of median age of 65 ± 1 year and 49% male, the one-year all-cause mortality and hospital mortality rates of Cancer COVID-19 Cohort, 30% and 20% respectively, were significantly higher than COVID-19 Cohort (9% and 8%), and Cancer Cohort (16% and 2%). The 12-month all-cause post-discharge mortality rate of Cancer COVID-19 Cohort (11%) was higher than COVID-19 Cohort (0.4%), but similar to Cancer Cohort (15%). The high 1-year all-cause mortality was among hematologic malignancies (65%) and then nasopharyngeal, brain and skin tumors (45%), digestive system (43%), and lung (32%). the rate was low among genitourinary (14%), female genital (13%), breast (11%), and thyroid (0). As for patients having at least one symptom at the 1-year follow-up, Cancer COVID-19 Cohort (23%, 26/114) is similar to COVID-19 Cohort (30%, 130/432). Discussion Cancer COVID-19 patients showed a high rate of hospitalization mortality, but not after discharged, signifying the strong acute adverse effect of COVID-19 on cancer patients while little was in long-term effect. Risk stratification showed that hematologic malignancies, nasopharyngeal, brain, digestive system and lung tumors were high risk, while genitourinary, female genital, breast and thyroid were low risk which was similar to non-cancer COVID-19. Conclusions COVID-19 had little effect of 1-year mortality and sequelae for cancer survivors discharged from SARS-CoV-2 virus infection. Different tumor subtypes had different effect of COVID-19. COVID-19 patients with thyroid, breast, female genital, genitourinary tumor had low risk mortality which was similar to non-cancer patients.
- Published
- 2021