AUTHOR=Russell Beth , Moss Charlotte , Papa Sophie , Irshad Sheeba , Ross Paul , Spicer James , Kordasti Shahram , Crawley Danielle , Wylie Harriet , Cahill Fidelma , Haire Anna , Zaki Kamarul , Rahman Fareen , Sita-Lumsden Ailsa , Josephs Debra , Enting Deborah , Lei Mary , Ghosh Sharmistha , Harrison Claire , Swampillai Angela , Sawyer Elinor , D'Souza Andrea , Gomberg Simon , Fields Paul , Wrench David , Raj Kavita , Gleeson Mary , Bailey Kate , Dillon Richard , Streetly Matthew , Rigg Anne , Sullivan Richard , Dolly Saoirse , Van Hemelrijck Mieke 

TITLE=Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.01279

DOI=10.3389/fonc.2020.01279

ISSN=2234-943X

ABSTRACT=<p><bold>Background:</bold> There is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies.</p><p><bold>Methods:</bold> We used data from a single large UK Cancer Center to assess the demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February and 12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death.</p><p><bold>Results:</bold> 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with a severe case of the disease. An initial cancer diagnosis &gt;24 months before COVID-19 [OR: 1.74 (95% CI: 0.71–4.26)], presenting with fever [6.21 (1.76–21.99)], dyspnea [2.60 (1.00–6.76)], gastro-intestinal symptoms [7.38 (2.71–20.16)], or higher levels of C-reactive protein [9.43 (0.73–121.12)] were linked with greater COVID-19 severity. During a median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Being of Asian ethnicity [3.73 (1.28–10.91)], receiving palliative treatment [5.74 (1.15–28.79)], having an initial cancer diagnosis &gt;24 months before [2.14 (1.04–4.44)], dyspnea [4.94 (1.99–12.25)], and increased CRP levels [10.35 (1.05–52.21)] were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin [0.04 (0.01–0.04)].</p><p><bold>Conclusions:</bold> A longer-established diagnosis of cancer was associated with increased severity of infection as well as COVID-19 death, possibly reflecting the effects a more advanced malignant disease has on this infection. Asian ethnicity and palliative treatment were also associated with COVID-19 death in cancer patients.</p>