Patients who have lived longer with cancer at greater risk of severe COVID-19 in
Cancer patients diagnosed more than 24 months ago are more likely to have a severe COVID-19 infection, research has found.
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.
Research published in Frontiers in Oncology by researchers at King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, and supported by the National Institute for Health Research (NIHR) Guy’s and St Thomas’ NHS Foundation Trust Biomedical Research Centre (BRC), examined the relationship between cancer and COVID-19.
The study analysed 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’ NHS Foundation Trust in London. Advanced statistical methods were employed to identify which demographic and/or clinical characteristics were associated with COVID-19 severity or death.
Cancer patients of Asian ethnicity or who were receiving palliative treatment for cancer were also at a higher risk of death from COVID-19.
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.
The most common tumour types were urological/gynaecological (29%), haematological (18%), and breast (15%). When classified according to COVID-19 severity, the largest proportion of cancers were haematological (36%), while 40% of patients had stage IV cancer and 46% of patients were diagnosed with malignancy in the last 12 months. Benign lung conditions were more commonly reported for those who presented with severe COVID-19.
Dr Mieke Van Hemelrijck, from the School of Cancer and Pharmaceutical Sciences, 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.
To read the full story, visit the King’s College London website.
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