Covid-19 in patients with hematological and solid cancers at a Comprehensive Cancer Center in Germany

Cancer Med. 2020 Nov;9(22):8412-8422. doi: 10.1002/cam4.3460. Epub 2020 Sep 15.

Abstract

Background: Patients with cancer are considered a high-risk group for viral pneumonia, with an increased probability of fatal outcome. Here, we investigated the clinical characteristics and outcome of patients with solid and hematological cancers and concomitant Covid-19 at a Comprehensive Cancer Center in a Covid-19 hotspot area in Germany.

Methods: We performed a retrospective single center cohort study of 39 patients with hematological and solid cancers who were hospitalized at the University Hospital Freiburg for Covid-19. Using univariate and multivariate Cox regression models we compared time to severe events and overall survival to an age-matched control cohort of 39 patients with confirmed Covid-19 without a cancer diagnosis.

Results: In the cancer cohort 29 patients had a diagnosis of a solid tumor, and 10 had a hematological malignancy. In total, eight patients (21%) in the cancer and 14 patients (36%) from the noncancer cohort died during the observation period. Presence of a malignancy was not significantly associated with survival or time to occurrence of severe events. Major influences on mortality were high IL-6 levels at Covid-19 diagnosis (HR = 6.95, P = .0121) and age ≥ 65 years (HR = 6.22, P = .0156).

Conclusions: Compared to an age-matched noncancer cohort, we did not observe an association between a cancer diagnosis and a more severe disease course or higher fatality rate in patients with Covid-19. Patients with a hematological malignancy showed a trend towards a longer duration until clinical improvement and longer hospitalization time compared to patients with a solid cancer. Cancer per se does not seem to be a confounder for dismal outcome in Covid-19.

Keywords: cancer management; epidemiology; epidemiology and prevention; viral infection.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / transmission
  • Coronavirus Infections / virology
  • Female
  • Germany / epidemiology
  • Hematologic Neoplasms / epidemiology*
  • Hematologic Neoplasms / virology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / epidemiology*
  • Neoplasms / virology
  • Oncology Service, Hospital / trends*
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / transmission
  • Pneumonia, Viral / virology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Survival Rate