A group of clinicians from New York City sought to determine if patients with cancer and COVID-19 in the United States have a poor prognosis. In an article published as a pre-proof in Annals of Oncology, Miyashita et al analyzed the electronic medical records from the Mount Sinai Health System, and found 334 patients (6%) with cancer among 5,688 patients diagnosed with COVID-19.
A previous retrospective case study from China included 28 patients with cancer and COVID-19 and showed a high mortality rate among these patients.
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Patient Data
The group of clinicians extracted data on sex, age, comorbidities, intubation, and mortality status from the electronic medical records of patients with COVID-19 as confirmed by a laboratory test from March 1 to April 6, 2020. Mortality was analyzed until April 8. Among the 334 patients analyzed, most had breast cancer (n = 57) or prostate cancer (n = 56), followed by lung cancer (n = 23), urothelial cancer (n =18) and colorectal cancer (n = 16).
Findings
The authors wrote that without adjusting for age, patients with cancer were intubated significantly more frequently than patients without cancer, but the rate of death was not significantly different. When stratifying patients by age, the researchers detected a significantly increased risk of intubation in patients with cancer aged 66 to 80 years; no significant difference in intubation risk was found in other age groups. Patients with cancer younger than age 50 had a significantly higher mortality rate than patients younger than 50 without cancer. However, the mortality rates from COVID-19 in patients with cancer were lower than those in patients without cancer in age groups older than 50, although they were not statistically significant.
The authors commented that cytokine-associated pulmonary injury is a potential etiology in patients with severe COVID-19. In young populations, baseline fragility among patients with cancer may lead to a relatively higher rate of deaths.
The authors also commented on the limitations of their data analysis, eg, unclear causation between COVID-19 and intubation or death, as well as heterogeneity of cancer types and various stages of cancer. However, the relatively large number of patients in the study allowed for the adjustment of age, which is one of the strongest prognostic factors.
The authors concluded that further study based on the individual patients’ data is needed to better understand the risk of COVID-19 in patients with cancer.
Disclosure: For full disclosures of the study authors, visit annalsofoncology.org.
