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- Title
Factors influencing COVID-19 mortality among cancer patients: A Brazilian multi-institutional study.
- Authors
da Silva, Jessé Lopes; de Souza, Bruno Santos Wance; de Albuquerque, Lucas Zanetti; Aleixo, Sabina Bandeira; Resende, Gilmara Anne da Silva; de Oliveira, Daniela Galvão Barros; dos Santos, Emerson Neves; Nogueira-Rodrigues, Angélica; Clara, Renan Orsati; Gaui, Maria de Fatima Dias; Mota, Augusto Cesar de Andrade; de Lima, Vladmir Claudio Cordeiro; Rosa, Daniela Dornelles; Munhoz, Rodrigo Ramella; Morbeck, Igor Alexandre Protzner; Gelatti, Ana Caroline Zimmer; Mathias, Clarissa Maria de Cerqueira; de Melo, Andréia Cristina
- Abstract
Purpose: This study aimed to describe the demographic and clinical characteristics of cancer patients with COVID-19, exploring factors associated with adverse outcomes. Patients and methods: This retrospective cohort study methodically extracted and curated data from electronic medical records (EMRs) of numerous healthcare institutions on cancer patients diagnosed with a confirmed SARS-CoV-2 infection between May 2020 and August 2021, to identify risk factors linked to extended hospitalization and mortality. The retrieved information encompassed the patients' demographic and clinical characteristics, including the incidence of prolonged hospitalization, acute complications, and COVID-19-related mortality. Results: A total of 1446 cancer patients with COVID-19 were identified (mean [Standard deviation] age, 59.2 [14.3] years). Most patients were female (913 [63.1%]), non-white (646 [44.7%]), with non-metastatic (818 [56.6%]) solid tumors (1318 [91.1%]), and undergoing chemotherapy (647 [44.7%]). The rate of extended hospitalization due to COVID-19 was 46% (n = 665), which was significantly impacted by age (p = 0.012), sex (p = 0.003), race and ethnicity (p = 0.049), the presence of two or more comorbidities (p = 0.006), hematologic malignancies (p = 0.013), metastatic disease (p = 0.002), and a performance status ≥ 2 (p = 0.001). The COVID-19-related mortality rate was 18.9% (n = 273), and metastatic disease (<0.001), performance status ≥2 (<0.001), extended hospitalization (p = 0.028), renal failure (p = 0.029), respiratory failure (p < 0.001), sepsis (p = 0.004), and shock (p = 0.040) significantly and negatively influenced survival. Conclusion: The rate of extended hospitalization and COVID-19-specific death in cancer patients was notably high and could be influenced by comorbidities, cancer treatment status, and clinical fragility. These observations may aid in developing risk counseling strategies regarding COVID-19 in individuals diagnosed with cancer.
- Subjects
CANCER-related mortality; COVID-19; ELECTRONIC health records; DEMOGRAPHIC characteristics; SEPSIS; COMORBIDITY; CANCER patients
- Publication
PLoS ONE, 2023, Vol 18, Issue 12, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0295597