Hui Peng,Sheng Wang,Qi Mei,Yuhong Dai,Jian Li,Ming Li,Kathrin Halfter,Xueyan Jiang,Qin Huang,Lei Wang,Wei Wei,Ru Liu,Zhen cao,Motuma Yigezu Daba,Fangfang Wang,Bingqing Zhou,Hong Qiu,Xianglin Yuan. Comparable outcomes but higher risks of prolonged viral RNA shedding duration and secondary infection in cancer survivors with COVID-19: A multi-center, matched retrospective cohort study*. Oncol Transl Med, 2020, 6: 237-246.
Comparable outcomes but higher risks of prolonged viral RNA shedding duration and secondary infection in cancer survivors with COVID-19: A multi-center, matched retrospective cohort study*
Received:November 12, 2020  Revised:December 29, 2020
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KeyWord:COVID-19; SARS-CoV-2; cancer survivor; prognosis; viral shedding; mortality
Author NameAffiliationE-mail
Hui Peng Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology denice1010@163.com 
Sheng Wang Department of Radiotherapy, Zhongda Hospital, Medical College of Southeast University  
Qi Mei Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  
Yuhong Dai Institute of Experimental Immunology, University Clinic of Rheinische Friedrich-Wilhelms-University, Bonn , Germany  
Jian Li Department of Oncology, Wuhan Pulmonary Hospital  
Ming Li Tumor Register Munich, Ludwig-Maximilian-University, Munich , Germany  
Kathrin Halfter Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, , China  
Xueyan Jiang Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  
Qin Huang Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  
Lei Wang Dangyang People’s Hospital  
Wei Wei Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  
Ru Liu Department of Pulmonary Vascular and General Medicine, Fuwai Yunnan Cardiovascular Hospital  
Zhen cao Whhan wuchang hospital,Wuhan, Hubei, China  
Motuma Yigezu Daba Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  
Fangfang Wang Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  
Bingqing Zhou Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  
Hong Qiu Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  
Xianglin Yuan Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology xlyuan1020@163.com 
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Abstract:
      Objective To identify the differences in clinical features and outcomes between cancer survivors and non-cancer patients with coronavirus disease 2019 (COVID-19). Methods In this multicenter, retrospective, and observational cohort study from February 10, 2020 to March 31, 2020 in Wuhan, China, all cancer survivors infected with COVID-19 were screened, and statistically matched with non-cancer patients with COVID-19 using propensity score matching. Demographic, clinical, treatment, and laboratory data were extracted from a standardized medical recording system and underwent review and assessment. Results Sixty-one cancer survivors and 183 matched non-cancer patients were screened from 2,828 COVID-19 infected patients admitted to 4 hospitals in Wuhan, China. The median ages of the cancer survivor cohort and non-cancer patient cohort were 64.0 (55.0–73.0) and 64.0 (54.0–73.5), respectively (P = 0.909). Cancer survivors reported a higher incidence of symptom onset than non-cancer patients. Fever (80.3% vs. 65.0%; P = 0.026) was the most prevalent symptom, followed by cough (65.6% vs. 37.7%; P < 0.001), myalgia, and fatigue (45.9% vs. 13.6%; P < 0.001). The risks of the development of severe events (adjusted hazard ratio [AHR] = 1.25; 95% confidence interval [CI]: 0.76–2.06; P = 0.378) and mortality (relative risk [RR] = 0.90, 95% CI: 0.79–1.04; P = 0.416) in the cancer survivor cohort were comparable to those of the matched non-cancer patient cohort. However, the cancer survivor cohort showed a higher incidence of secondary infection (52.5% vs. 30.1%; RR = 1.47, 95% CI: 1.11–1.95; P = 0.002) and a prolonged viral RNA shedding duration (32 days [IQR 26.0–46.0] vs.24.0 days [IQR 18.0–33.0]; AHR = 0.54; 95% CI: 0.38–0.80; P < 0.05). Conclusion Compared to non-cancer patients, cancer survivors with COVID-19 exhibited a higher incidence of secondary infection, a prolonged period of viral shedding, but comparable risks of the development of severe events and mortality. It is helpful for clinicians to take tailored measures to treat cancer survivors with COVID-19.
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