| 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 Name | Affiliation | E-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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