Factors influencing in-hospital mortality in cancer patients with COVID-19: A retrospective survival analysis.

OBJECTIVE

The aim of this study was to evaluate survival in patients with COVID-19 and cancer, and to find factors associated with early mortality.

METHODS

Retrospective cohort derived from a registry of a referral center in Bogotá. Survival was analyzed according to the type of neoplasm using Kaplan-Meier method. A cox regression was performed to look for factors associated to higher risk of death.

RESULTS

Two hundred fifty-four patients were included with cancer and COVID-19, most of whom were women (median age 68 years; range 19-97). Cardiovascular comorbidities were frequent. Patients with hematologic neoplasms had higher survival than those with solid neoplasms (log-rank test,  = 0.024). C-reactive protein levels (hazard ratio 1.02; 95% confidence interval 1.00-1.03,  = 0.025), Charlson's comorbidity index (hazard ratio 1.15; 95% confidence interval 1.06-1.26,  = 0.004) and respiratory failure (hazard ratio 4.83; 95% confidence interval 2.47-9.44,  = <0.001) were significantly associated with higher mortality. No interaction between active anticancer therapy and mortality was observed.

CONCLUSION

In contrast to other reports, survival was worse in patients with solid tumors than in those with hematologic neoplasms. Increased C-reactive protein, Charlson's comorbidity index and respiratory failure were associated with higher in-hospital mortality. This study reveals the complex impact of cancer and its treatment on COVID-19 outcomes, highlighting the persistent risks to cancer patients. It emphasizes monitoring C-reactive protein levels, comorbidities, and respiratory failure as key indicators of poor prognosis. Furthermore, we provide new insights into the differential impact of COVID-19 on cancer patients with solid organ versus hematologic neoplasms.