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%CI 2.34–7.75;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.