COVID-19 and Cancer: A Comparative Case Series

Background: Cancer patients, with an incidence of more than 18 million new cases per year, may constitute a significant portion of the COVID-19 infected population. In the pandemic situation, these patients are considered highly vulnerable to infectious complications due to their immunocompromised state.

Material & Methods: In this retrospective case series, the documents of solid cancer patients infected by SARS-CoV-2, hospitalized in Shariati hospital between 20 February and 20 April 2020, were evaluated. The diagnosis of COVID-19 was based on laboratory-confirmed COVID-19 and/or features of chest CT scan highly suggestive for SARS-CoV-2.

Results: A total of 33 COVID-19-infected cancer patients were included. Mean age was 63.9 years, and 54.5% of the patients were male. LDH level was significantly higher (1487.5 ± 1392.8 vs. 932.3 ± 324.7 U/L, P-value=0.016) and also serum albumin was significantly lower in non-survivors (3.6 ± 0.5 vs. 2.9 ± 0.6 g/dL, p-value=0.03). Among 16 patients with stage IV cancer, thirteen patients died, which was significantly higher compared to stage I-III cancer patients (81.3% vs. 18.8% P-value= <0.001). In terms of developing complications, sepsis, invasive ventilation and mortality was significantly higher in patients who received cytotoxic chemotherapy within the last 14 days.

Conclusion: In this study, we showed that the mortality rate among cancer patients affected by COVID-19 was higher than general population and this rate has a significant correlation with factors including the stage of the disease, the type of cancer, the activity of cancer and finally receiving cytotoxic chemotherapy within 14 days before diagnosis of COVID-19.