Clinical Characteristics, Risk Factors and Cardiac Manifestations of Cancer Patients with COVID-19

Abstract

Background: Coronavirus disease 2019 (COVID-19) has been associated with cardiovascular features, which may be deteriorated in cancer patients. \n \nMethods: We retrospectively assessed 1,244 COVID-19 patients from February 1st to August 31st (140 cancer and 1104 non-cancer patients). Clinical data and laboratory findings were obtained and compared between cancer and non-cancer groups. Risk factors for in-hospital mortality were identified by multivariable COX regression models. \n \nFindings: The median age of cancer group was older than that in non-cancer patients [61 (57-67) vs. 56 (40-68), p < 0.001]. For cancer group, 56% were in severe and critical status, while the proportion was 10% for non-cancer group. Cancer patients had increased levels of leukocyte, neutrophil count and BUN (all p < 0.01), while lymphocyte count was significantly lower (p < 0.001). The most common solid tumor types were gastrointestinal cancer (26%), lung cancer (21%), breast and reproductive cancer (both 19%). There is a rising for cardiac biomarkers, including Pro-BNP, cTnI, MYO, CK-MB, and D-Dimer in COVID-19 cancer population, especially in deceased cancer subjects. The 30-day in hospital mortality in cancer group was dramatically raised than that in non-cancer group (12.9% vs. 4.0%, p<0.01). In multivariable COX regression models, fever, disease severity status, underlying diseases were risk factors for mortality. The Pro-BNP and D-Dimer levels were significantly increased in cancer subjects with cardiovascular disease. \n \nInterpretation: COVID-19 cancer patients relate to deteriorating conditions, increased risk of admission to intensive care units and in-hospital mortality. They display severely impaired myocardium, damaged heart function and imbalanced homeostasis of coagulation, which warrants more aggressive treatment.\xa0 \n \nFunding: The current work was supported by the National Natural Science Foundation Project of China (Grant No. 81670304) and the Fundamental Research Funds for the Central Universities of China (NO.2042019kf0058). \n \nDeclaration of Interests: All authors report no relationship or conflict of interest to disclose. \n \nEthics Approval Statement: This study was approved by the National Health Commission of China and the institutional review board at Renmin Hospital of Wuhan University (Wuhan, China).