COVID-19 Positive Cancer Patients Undergoing Active Cancer Treatment: An Analysis of Clinical Features and Outcomes

Ali, Jamshed; Sajjad, Kashif; Rehman Farooqi, Amer; Tahir Aziz, Muhammad; Rahat, Ayesha; Khan, Sarah

Background Cancer patients particularly those on active anti-cancer treatment have been reported to be at a high risk of severe COVID-19 infection and deaths. This study aimed to describe the clinical characteristics and outcomes of patients diagnosed with COVID-19 whilst on anti-cancer treatment in a developing country. Methods This is a retrospective observational study of all adult cancer patients at SKMCH & RC Pakistan, from 15th March - 10th July,2020 diagnosed with COVID-19 within 4 weeks of receiving anti-cancer treatment, where a purposive sampling was carried out. Cancer Patients who did not receive anti-cancer treatment and clinical or radiological diagnosis of COVID-19 without a positive RT-PCR test were excluded. The primary endpoint was all-cause mortality after 30 days of COVID‐19 test. Data was analyzed through SPSS version 23. Categorical parameters were computed using Chi-Square test, keeping p-value <0.05 as significant. Results A total of 201 cancer patients with COVID‐19 were analyzed. The median age of patients was 45 (18-78) years. Mild symptoms were present in 162(80.6%) patients and 39(19.4%) had severe symptoms. The risk of death was statistically significant (p-value <0.05) amongst patients above 50 years of age, with metastatic disease and on palliative anti-cancer treatment. Anti-cancer treatment (chemotherapy, radiotherapy, hormonal therapy, targeted therapy and surgery) recieved within preceding 4 weeks, had no statistically significant (p-value >0.05) impact on mortality. Conclusion In cancer patients with COVID-19, mortality appears to be principally driven by age, advanced stage of the disease and palliative intent of cancer treatment. We did not identify evidence that cancer patients on chemotherapy are at significant risk of mortality from COVID-19 correlating to those not on chemotherapy.