The Study of COVID-19 Disease Severity and Associated Risk Factors in Cancer Patients

Abstract

Background: Since the storm of COVID-19 infection began, most people believe that cancer patients have immune exhaustion (whether caused by the disease itself or the treatment), which causes a higher risk and severity of covid-19 infection. However, some extensive studies could not show evidence that cancer patients on anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment. This study aims to reveal the COVID-19 outcomes in patients with cancer at Surin hospital cancer center.
Methods: A retrospective study was conducted between October 2019 and June 2022. All medical records of 189 patients were reviewed for demographic data and cancer patients' severity of the COVID-19 infection. The prognostic factors were performed by a flexible parametric regression model, both univariate and multivariate analysis. The Surin hospital's IRB approved this study.
Results: Between October 2019 and June 2022, 189 eligible patients had confirmed cancer diagnosed and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The prevalence of COVID-19 infection in cancer patients was 4.4%, comparable with the general population prevalence (approximately 3.8%). covid upper respiratory tract infection and covid pneumonia were 83.6% and 16.4, respectively. By univariate analysis, extremely aged cancer patients (≥ 75 yrs.), co-morbidity, or being unvaccinated were negatively affected by the disease prognosis. older age (≥ 75 years) (OR 4.47; 95% CI 1.752 – 11.416; p = 0.002) or un-vaccination (OR 2.66; 95% CI 1.131-6.235; p = 0.025) were independent poor prognostic factors for severity. Surprisingly, the patients with or without active anticancer treatment (OR 1.46; 95%CI 0.430-0.449; p=0.433) or who had primary or secondary lung cancer or not (OR 1.366; 95%CI 1.000-1.000; p=0.822) were similarly severity of COVID-19 infection. The mortality rate of COVID-19 patients with cancer was higher than the general population, 2.1% vs. 0.5%, respectively, and all of them were female and could not receive the third dose of a COVID-19 vaccine.
Conclusion: As expected, the prevalence of COVID-19 infection among cancer patients was enriching compared with the general population (4.4% vs. 3.8%). And those who are highly aged (≥ 75 yrs.), had co-morbidity, or unvaccinated could negatively affect disease prognosis.