Patients diagnosed with cancer more for more than 24 months are more likely to have a severe COVID-19 infection because the diagnosis of the infection is most likely to be missed or delayed by similar symptoms of cancer. Cancer patients of Asian ethnicity or those who were receiving palliative treatment for cancer were also at a higher risk of death from COVID-19. The research published today in Frontiers in Oncology by researchers at King's College London and Guy's and St Thomas' Foundation Trust, and supported by the NIHR Guy's and St Thomas' BRC, examined the relationship between cancer and COVID-19.
‘Patients diagnosed with cancer more than 24 months before the onset of COVID-19 are at higher risk of dying from the infection. Patients who have shortness of breath or high levels of a standard blood marker of inflammation are also at higher risk of dying from COVID-19.’
There are limited studies investigating cancer patients and COVID-19, with small sample sizes that have yet to distinguish between the effects of age, cancer, and other comorbidities on COVID-19 in the cancer population. It can be difficult to diagnose COVID-19 in cancer patients as symptoms can look similar to cancer symptoms and adverse effects of cancer treatments. This can result in a delayed or missed COVID-19 diagnosis, which could lead to severe infection or higher death rates.The study analyzed the outcomes of 156 cancer patients with confirmed COVID-19 diagnosis between 29 February and 12 May 2020. 82% of patients had presented with mild or moderate COVID-19 infection and 18% with severe disease at Guy's Cancer Centre, at Guy's and St Thomas' in London. Advanced statistical methods were employed to identify which demographic and/or clinical characteristics were associated with COVID-19 severity or death.
Patient follow ups conducted 37 days later found 22% of patients from the cohort had died from COVID-19 infection. Patients with Asian ethnicity, palliative treatment, or a diagnosis of cancer more than 24 months before onset of COVID-19 symptoms were at higher risk of dying. Patients who presented with dyspnoea (shortness of breath) or high CRP levels (common blood marker of inflammation) were also at higher risk of dying from COVID-19.
Severe COVID-19 infection was associated with presenting with fever, dyspnoea, gastro-intestinal symptoms or a diagnosis of cancer more than 24 months previously.
Most patients in the cohort were male, from a lower socio-economic background; half were White, 22% Black and 4% Asian. Hypertension was the most reported comorbidity followed by diabetes, renal impairment and cardiovascular disease.
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Dr Mieke Van Hemelrijck, from King's College London, said: "Large studies with detailed information on COVID-19 safety measures and oncological care are urgently warranted to explore the intersection of COVID-19 and cancer in terms of clinical outcomes, so as to inform oncological care during this outbreak and potential future pandemics. Our findings provide a first insight into possible effects of cancer and its treatments on COVID-19 outcomes."
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"This real-world observation provides valuable insights into our cancer patients during the COVID pandemic. The data needs to be validated in larger series with longer follow-up of patients to provide more definitive guidance on the management of oncology patients through the COVID-19 outbreak."
Source-Eurekalert