More Severe COVID-19 in Patients With Active Cancer: Results of a Multicenter Cohort Study
Caterina Monari, Caterina Sagnelli, Paolo Maggi, Vincenzo Sangiovanni, Fabio Giuliano Numis, Ivan Gentile, Alfonso Masullo, Carolina Rescigno, Giosuele Calabria, Matteo Megna, Michele Gambardella, Elio Manzillo, Grazia Russo, Vincenzo Esposito, Clarissa Camaioni, Vincenzo Messina, Mariantonietta Pisaturo, Enrico Allegorico, Biagio Pinchera, Raffaella Pisapia, Mario Catalano, Angela Salzillo, Giovanni Porta, Giuseppe Signoriello, Nicola Coppola
Abstract
BACKGROUND: The aim of the study was to compare coronavirus disease 2019 (COVID-19) severity presentation between oncologic and non-oncologic patients and to evaluate the impact of cancer type and stage on COVID-19 course. METHODS: We performed a multicentre, retrospective study involving 13 COVID-19 Units in Campania region from February to May 2020. We defined as severe COVID-19 presentation the cases that required mechanical ventilation and/or admission to Intensive Care Units (ICU) and/or in case of death. RESULTS: We enrolled 371 COVID-19 patients, of whom 34 (9.2%) had a history or a diagnosis of cancer (24 solid, 6 onco-hematological). Oncologic patients were older (p<0.001), had more comorbidities (p<0.001) and showed a higher rate of severe COVID-19 presentation (p=0.001) and of death (p<0.001). Compared to 12 patients with non-active cancer and to 337 without cancer, the 17 patients with active cancer had more comorbidities and showed a higher rate of severe COVID-19 and of mortality (all p values <0.001). Compared to the 281 non-severe patients, the 90 subjects with a severe presentation of COVID-19 were older (p<0.01), with more comorbidities (p<0.001) and with a higher rate of cancer (p=0.001). At multivariate analysis, age (OR 1.08, 95% CI: 1.04-1.11) and suffering from cancer in an active stage (OR 5.33, 95% CI: 1.77-16.53) were independently associated with severe COVID-19. CONCLUSIONS: Since the higher risk of severe evolution of COVID-19, cancer patients, especially those with an active malignancy, should be candidates for early evaluation of symptoms and early treatment for COVID-19.