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Cited by 584COVID-19 and healthcare impactsCOVID-19 Clinical Research StudiesCOVID-19 Impact on Reproduction

Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study

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Yang, Kunyu, Sheng, Yuhan, Huang, Chaolin, Jin, Yang, Xiong, Nian, Jiang, Ke, Lu, Hongda, Liu, Jing +16 more·2020·The Lancet Oncology
DOI 10.1016/s1470-2045(20)30310-7PMC PMC7259917
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Abstract

Background Patients with cancer are a high-risk population in the COVID-19 pandemic. We aimed to describe clinical characteristics and outcomes of patients with cancer and COVID-19, and examined risk factors for mortality in this population.Methods We did a retrospective, multicentre, cohort study of 205 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and with a pathological diagnosis of a malignant tumour in nine hospitals within Hubei, China, from Jan 13 to March 18, 2020. All patients were either discharged from hospitals or had died by April 20, 2020. Clinical characteristics, laboratory data, and cancer histories were compared between survivors and non-survivors by use of χ 2 test. Risk factors for mortality were identified by univariable and multivariable logistic regression models.Findings Between Jan 13 and Mar 18, 2020, 205 patients with cancer and laboratory-confirmed SARS-CoV-2 infection were enrolled (median age 63 years [IQR 56-70; range 14-96]; 109 [53%] women). 183 (89%) had solid tumours and 22 (11%) had haematological malignancies. The median duration of follow-up was 68 days (IQR 59-78). The most common solid tumour types were breast (40 [20%] patients), colorectal (28 [14%]), and lung cancer (24 [12%]). 54 (30%) of 182 patients received antitumour therapies within 4 weeks before symptom onset. 30 (15%) of 205 patients were transferred to an intensive care unit and 40 (20%) died during hospital admission. Patients with haematological malignancies had poorer prognoses than did those with solid tumours: nine (41%) of 22 patients with haematological malignancies died versus 31 (17%) of 183 patients with solid tumours (hazard ratio for death 3·28 [95% CI 1·56-6·91]; log rank p=0·0009). Multivariable regression analysis showed that receiving chemotherapy within 4 weeks before symptom onset (odds ratio [OR] 3·51 [95% CI 1·16-10·59]; p=0·026) and male sex (OR 3·86 [95% CI 1·57-9·50]; p=0·0033) were risk factors for death during admission to hospital.Interpretation Patients with cancer and COVID-19 who were admitted to hospital had a high case-fatality rate. Unfavourable prognostic factors, including receiving chemotherapy within 4 weeks before symptom onset and male sex, might help clinicians to identify patients at high risk of fatal outcomes.Funding National Natural Science Foundation of China.

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  • Among patients who developed severe disease, median time to dyspnea was 5 to 8 days, median time to ARDS was 8 to 12 days, and median time to intensive care unit admission was 10 to 12 days after symptom onset.

    “Additional studies found that, among patients who developed severe disease, the median time to dyspnea was 5 to 8 days, the median time to ARDS was 8 to 12 days, and the median time to intensive care unit admission was 10 to 12 days after symptom onset (68–70).”

    From Lung epithelial and endothelial damage, loss of tissue repair, inhibition of fibrinolysis, and cellular senescence in fatal COVID-19 (2021) · cites this paper as [69]

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Authors
Yang, K., Sheng, Y., Huang, C., Jin, Y., Xiong, N., Jiang, K., Lu, H., Liu, J., Yang, J., Dong, Y., Pan, D., Shu, C., Li, J., Wei, J., Huang, Y., Peng, L., Wu, M., Zhang, R., Wu, B., Li, Y., Cai, L., Li, G., Zhang, T., & Wu, G.
Affiliations
  • Wuhan Union Hospital (CN)
  • Jinyintan Hospital (CN)
  • Central Hospital of Wuhan (CN)
  • Huanggang Central Hospital (CN)
  • Yangtze University (CN)
  • Hubei University of Medicine (CN)
  • Xianning Central Hospital (CN)
  • The Central Hospital of Xiao gan (CN)
Corresponding author
Wu, Gang
ORCID
Venue
The Lancet Oncology
Publisher
Elsevier BV
Published
2020-07
Volume
21
Issue
7
Pages
904-913
ISSN
1470-2045 (ISSN-L)
DOI
10.1016/s1470-2045(20)30310-7
PMC
PMC7259917
OpenAlex
W3031584350
Cited by
584
References
32
Citations by year
2026: 12 · 2025: 21 · 2024: 38 · 2023: 61 · 2022: 120 · 2021: 210 · 2020: 118 · 2019: 2 · 2014: 1
FWCI
45.96
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Oncology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Natural Science Foundation of China (81874218, NSFC 81672978)
Topics
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
Keywords
COVID-19 pandemic, SARS-CoV-2, cancer, mortality risk factors, hematologic malignancies, solid tumors, chemotherapy timing, cancer therapy, intensive care unit admission, prognostic factors, breast cancer, colorectal cancer, lung cancer, H1N1 influenza pandemic
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Aged, 80 and over, China, Female, Humans, Male, Middle Aged, Neoplasms, Pneumonia, Viral, Prognosis, Retrospective Studies, Risk Factors, Severity of Illness Index, Treatment Outcome, Coronavirus Infections, Young Adult, Pandemics

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