The burden of COVID-19 death for different cancer types: a large population-based study.

in Journal of global health by You Mo, Duncan Wei, Xiaozheng Chen, Zengfu Zhang, Wen Huo, Meng Wu, Dawei Chen, Jinming Yu

TLDR

  • The study found that 5.3% of cancer patients died from COVID-19, with chronic lymphocytic leukaemia exhibiting the highest mortality rate, and years from cancer diagnosis independently predicting COVID-19 death.

Abstract

Viral mutations and immune dysfunction still lead to recurrent infections of COVID-19 in cancer patients. Our aim in this study was to explore the differences in cumulative risk of COVID-19 death from different cancer types and characterise clinical and demographic factors associated with COVID-19 death. We conducted a population-based study using the National Cancer Database, which included all cancer types. We calculated age-standardised mortality, cancer mortality, and COVID-19 mortality. Further, we employed a multivariate competing risk analysis to calculate the cumulative risk of COVID-19 death in different cancer types. 5.3% of cancer patients suffered from COVID-19 death. The highest COVID-19 mortality was in chronic lymphocytic leukaemia, while lung and bronchus cancer exhibited lower risk. Notably, years from cancer diagnosis independently predict COVID-19 death. The hazard ratios (HR) in different types of cancers were as follows: lung and bronchus cancer HR = 1.29 (95% confidence interval (CI) = 1.20-1.40, P < 0.001), colon and rectum cancer HR = 1.22 (95% CI = 1.16-1.29, P < 0.001), urinary bladder cancer HR = 1.22 (95% CI = 1.15-1.30, P < 0.001), non-Hodgkin lymphoma HR = 1.17 (95% CI = 1.11-1.23, P < 0.001), kidney cancer HR = 1.15 (95% CI = 1.06-1.24, P < 0.001), and breast cancer HR = 1.11 (95% CI = 1.06-1.16, P < 0.001). Radiotherapy, chemotherapy, and surgical resection did not significantly correlate with COVID-19 death. We revealed the burden of COVID-19 death across different cancer types. COVID-19 mortality was highest in chronic lymphocytic leukaemia and prostate cancer, while patients with lung and bronchus cancer had a lower risk. Years from diagnosis independently predict COVID-19 death. Based on the results, we support more prompt risk assessment and treatment for various types of cancer.

Overview

  • The study aimed to investigate the differences in the cumulative risk of COVID-19 death in patients with various cancer types and identify clinical and demographic factors associated with COVID-19 death.
  • The study utilized the National Cancer Database to analyze the data and employed a multivariate competing risk analysis to calculate the cumulative risk of COVID-19 death in different cancer types.
  • The primary objective of the study was to identify the burden of COVID-19 death across different cancer types and to better understand the factors that contribute to COVID-19 mortality in cancer patients.

Comparative Analysis & Findings

  • The study found that 5.3% of cancer patients suffered from COVID-19 death, with the highest mortality rate observed in chronic lymphocytic leukaemia.
  • The hazard ratios (HR) for COVID-19 mortality were highest in lung and bronchus cancer (HR=1.29), colon and rectum cancer (HR=1.22), urinary bladder cancer (HR=1.22), non-Hodgkin lymphoma (HR=1.17), kidney cancer (HR=1.15), and breast cancer (HR=1.11).
  • The years from cancer diagnosis independently predicted COVID-19 death, and the use of radiotherapy, chemotherapy, and surgical resection did not significantly correlate with COVID-19 mortality.

Implications and Future Directions

  • The study highlights the importance of prompt risk assessment and treatment for various types of cancer to mitigate the risk of COVID-19 death.
  • Future studies should investigate the specific mechanisms underlying COVID-19 mortality in cancer patients and explore novel therapeutic approaches to improve outcomes.
  • The findings of this study suggest that healthcare providers should consider the patient's cancer type and duration since diagnosis when assessing their risk of COVID-19 death and informing treatment decisions.
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