Factors affecting the mortality rate of patients with cancer hospitalized with COVID-19: a single center’s experience

Abstract

The main objective is to define the mortality of patients with cancer admitted to our hospital, their clinical and demographic characteristics, investigate the risk of COVID-19 for patients with cancer, and determine factors that affect the mortality rates of patients with cancer dying of COVID-19. A total of 2401 patients were admitted to our hospital with the diagnosis of COVID-19 from March 11th, 2020, to May 31st, 2020. Ninety-two out of a total of 112 cancer patients were included in this study based on the planned inclusion/exclusion criteria. The clinical, demographic, and laboratory features and treatments provided were studied, and their effect on mortality rates was analyzed. In our study the median age of the patients was 67 years, and 55.4% were male. More than half (56.5%) of our patients had metastasis. The mortality rate was 6.2% in the overall population with COVID-19, whereas it was 23.9% in patients with cancer. The mortality rate in patients with metastasis was statistically significantly higher compared with those without metastasis (34.0% vs. 10.3% P = 0.008). The mortality rate in patients still smoking was statistically significantly higher than in non-smokers (37.5% vs. 12.5% P = 0.033). The mortality rates of patients with high average C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), and D-dimer levels were statistically significantly higher than in those without, and the mortality rates of patients with lower average albumin and hemoglobin levels were statistically significantly higher than those without (P < 0.001, P = 0.006, P = 0.041, P < 0.001, P < 0.001, and P = 0.028, respectively). Having metastases concurrent with COVID-19 was a statistically significant factor predictive of prognosis. Also, high CRP, ferritin, LDH, and D-dimer, and low albumin and hemoglobin were related to increased mortality rates. The predictive and prognostic role of possible factors related to prognosis is still unknown and further large, multicenter prospective studies are needed to confirm these results.

Keywords:

• Cancer
• COVID-19
• mortality rate
• metastatic stage
• smoking
• treatment

Disclosure statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Statement of ethics

The study was approved by the Ethics Committee of the Istanbul Kartal Dr. Lutfi Kirdar City Hospital

Additional information

Notes on contributors

Murat Ayhan

Murat Ayhan was graduated from the Dicle University in 2007. He currently training medical oncology fellowship at Kartal Dr. Lutfi Kirdar City Hospital. His current research interests include breast cancer, genitourinary cancers and lung cancer. He have about 10 publications in oncology fields.

Hatice Odabas

Hatice Odabas has been practicing in the Department of Oncology at Kartal Dr Lütfi Kırdal City Hospital in İstanbul since 2013. She received the title of associate professor in 2017. Her practice focuses on lung cancer, breast cancer and colon cancer also works clinical research which anticancer drug therapies that are in phase III of clinical trials. Having over 20 publications in sci journals, Dr. Odabaş is a member of the Turkish Medical Oncology Association.

Nedim Turan

Nedim Turan was graduated from the Çukurova University in 1998. He gained his Medical Oncologist degree in 2012 from the University of Gazi in Ankara. He is currently working in Medical Oncology Department (managing cancer patients with chemical agent, biological agent and immunotherapy) at SBU as a professor. His current research interests include gastrointestinal cancers and chemotherapy. He has over 30 publications in oncology fields.

Deniz Tataroglu Ozyukseler

Deniz Tataroglu Ozyukseler was graduated from Istanbul University Istanbul Medical Faculty in 2011. She gained her Medical Oncologist degree in 2020 from Kartal Dr. Lutfi Kirdar City Hospital in Istanbul. She is currently working in Medical Oncology Department (managing cancer patients with chemical agent, biological agent and immunotherapy) at Kartal Dr. Lutfi Kirdar City Hospital. She attends clinical trials since 2018 as a sub-investigator. Her current research interests include gastrointestinal cancers, breast cancer and lung cancer. She is highly proficient in English.

Osman Kostek

Osman Kostek was graduated from Marmara University in 2010. He gained his Medical oncologist degree in 2019 from the Trakya University in Edirne. He received the title of associate professor in 2020. He is currently working in Medical Oncology departmant at Edirne state hospital. His current research interests include lung cancers and gastrointestinal cancers.

Gulin Alkan

Gulin Alkan was graduated from the İstanbul University Cerrahpaşa Medical Faculty in 2008. She completed her internal medicine residency in İstanbul University İstanbul Medical Faculty in 2015. She is currently training medical oncology fellowship at Istanbul University Cerrahpaşa-Cerrahpaşa Medical Faculty. Her current research interests include breast cancer, genitourinary cancers and sarcomas.

Evrim Abamor

Evrim Abamor was gratuated with well grade from Ankara University Faculty of Medicine in 1995. She gained her Nuclear Medicine Specialist degreeat Gazi University Faculty of Medicinein 2001. From that time,she worked in university hospitals and research – education hospitals as nuclear medicine specialist. She is currentlyin charge as department manager of Nuclear Medicine Department at Kartal Dr. Lütfi Kırdar City Hospital. She is mostly working in nuclear oncology field in diagnosis, staging, theraphy response and reevaluation of cancer patients with molecular imaging. She is also interested in the ranostics, peptide reseptor radionuclide theraphy. Her research interests include molecular imaging and theraphy response in cancer patients. She has more than ten publications and medical congress notices in nuclear oncology studies.

Mahmut Emre Yildirim

Mahmut Emre Yildirim was graduated from İstanbul University Cerrahpaşa Medical Faculty in 2002. He gained his Medical oncologist degree in 2011 from Kartal Dr. Lutfi Kirdar City Hospital in Istanbul. He received the title of associate professor in 2017. He is currently working in Medical Oncology Department (managing cancer patients with chemical agent, biological agent and immunotherapy) at Kartal Dr. Lutfi Kirdar City Hospital.