Clinical Presentations and Outcomes of Coronavirus Disease 2019 in Patients With Solid Tumors

Imran Farooque; Umar Farooque; Sundas Karimi; Muhammad Usman Shah Syed; Zubia Nadeem; Arif Zulfiqar; Sufyan Mustafa; Rizwan Farooque; Ayyaz A Sultan; Syed Adeel Hassan

doi:10.7759/cureus.15452

Clinical Presentations and Outcomes of Coronavirus Disease 2019 in Patients With Solid Tumors

Cureus. 2021 Jun 5;13(6):e15452. doi: 10.7759/cureus.15452. eCollection 2021 Jun.

Authors

Affiliations

¹ Public Health, Peoples University of Medical and Health Sciences for Women, Nawabshah, PAK.
² Neurology, Dow University of Health Sciences, Karachi, PAK.
³ Orthopedic Surgery, Dow University Hospital, Karachi, PAK.
⁴ Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
⁵ Medicine, Dow University of Health Sciences, Karachi, PAK.
⁶ Medicine and Surgery, Dow Medical College, Karachi, PAK.
⁷ Medicine, Dow Medical College, Civil Hospital, Karachi, PAK.
⁸ Internal Medicine, Sindh Medical College, Karachi, PAK.
⁹ Hematology/Oncology, California Cancer Associates for Research & Excellence, Fresno, USA.
¹⁰ Internal Medicine, University of Louisville, Louisville, USA.

Abstract

Background Coronavirus disease 2019 (COVID-19) is a global health crisis. The literature suggests that cancer patients are more prone to be affected by COVID-19 because cancer suppresses the immune system and such patients usually present poor results. The objective of this study is to present all clinical, laboratory, and demographic characteristics of COVID-19 patients with solid tumors. Methodology This study was conducted at the Dow University of Health Sciences for a period of six months from April 2020 to September 2020. In this study, we included a total of 1,519 confirmed patients diagnosed with solid tumors via polymerase chain reaction. The mortality timeline within 30 days of contracting the virus was considered, and the median age of the included individuals was 61 years, with a range of 20-95 years. Of the patients included in the study, 49.4% (750) were men; moreover, 3.15% of our study population had prostate cancer, 10.20% had colorectal cancer, 2.76% had breast cancer, and 10.46% had lung cancer. Of the patients, 25.93% presented with at least one comorbidity. For 73% of the patients, at least one direct therapy for COVID-19 was included in the treatment; 56.6% of the patients were hospitalized, and 11.32% were admitted to the intensive care unit. Results The mortality rate was 4.74% in the first 30 days after diagnosis, where 72 patients died. The findings of the first multi-variation model showed that males at older ages who were diabetic and going through cytotoxic therapy were prone to die within the first 30 days. However, the 30-day mortality rate was lower in patients diagnosed with prostate and breast cancer. The second set incorporated laboratory factors, where we found that higher values of leukocytosis, thrombocytopenia, and lymphocytopenia were correlated with higher rates of mortality within 30 days. Conclusions We conclude that there is a higher mortality rate of COVID-19 in patients with solid tumors than in the general population. However, it was found to be lower in the Pakistani population compared with the Chinese and Western populations. Intensive care can decrease mortality rates in COVID-19 and cancer patients.

Keywords: breast cancer; clinical presentation; colorectal cancer; covid-19; lung cancer; mortality; outcomes; pandemic; prostate cancer; solid tumor.