In an analysis of data from 14 hospitals in Wuhan, China -- where the outbreak of the new coronavirus, SARS-CoV-2, first came to light -- cancer patients were nearly twice as likely to experience severe symptoms from the virus and twice as likely to die as a result of infection, according to a multi-national team of researchers.
If the findings are confirmed in additional studies, cancer could join heart disease and diabetes as underlying conditions that pose the greatest risk with the disease caused by the new coronavirus, the authors said.
"Although the study was limited to a single province in China, it is a first step toward quantifying the effect of COVID-19 on oncology patients," co-author Dr. Mauricio Santillana, of the Computational Health Informatics Program, at Boston Children's Hospital, said in a statement. "This was still a relatively small sample, so as we get more data we expect our estimates will change."
As of Tuesday, more than 1 million Americans have been diagnosed with COVID-19, and more than 57,000 have died, according to Johns Hopkins University.
To date, information on risks linked to the virus for cancer patients has been limited, although data posted in late March by the U.S. Centers for Disease Control and Prevention indicated that the disease was among those that could contribute to serious illness in some patients. In all, 29 of the patients in that report that required hospitalization to treat COVID-19 had cancer, far fewer than those with conditions like diabetes and heart disease.
Working with researchers in Wuhan, Santilla and colleagues reviewed data on 105 COVID-19 patients with cancer and 536 COVID-19 patients without cancer, matched for age, hospital and hospitalization time, adjusting for sex, smoking and other health conditions known to increase risk, among other variables.
They found that COVID-19 patients with cancer had a nearly two-fold risk of experiencing severe symptoms, a three-fold risk for admission to a hospital intensive care unit, a 2.7-fold likelihood of going on a ventilator and a two-fold risk for death, compared to those without cancer.
In addition, they noted that the greatest increase in risk was seen among patients with metastatic, or stage IV, cancers. Those in this group had a nearly six-fold increased risk for death, a nearly seven-fold increased risk for ICU admission, a six-fold increased risk for severe disease and a 55-fold increased likelihood of a need for invasive ventilation.
Among various cancer, blood cancers like leukemia, lymphoma and myeloma posed the greatest risk for worse COVID-19 prognosis, followed by lung cancer. Those with all forms of cancer had similar COVID-19 prognosis regardless of whether or not they were still receiving treatment for their cancers.
Notably, patients with non-metastatic cancer did not have significantly different risks than patients without cancer, the authors said.
The study, which was also published by the journal Cancer Discovery on Tuesday, is the first large cohort study to examine COVID-19 outcomes in cancer patients. The research was funded by the National Natural Science Foundation of China and the U.S. National Institutes of Health, among others, and began when clinicians in Wuhan reached out to CHIP for assistance.
"Multiple teams came together from different scientific disciplines with the hope of being helpful," Santillana explained in a statement. "It is important to continue to monitor how oncology patients are responding to the virus."