A Multicenter Study of Coronavirus Disease 2019 Outcomes of Cancer Patients in Wuhan, China

  1. Hongyan Zhang
  2. Linwei Wang
  3. Yuanyuan Chen
  4. Xiaokun Shen
  5. Qun Wang
  6. Youqin Yan
  7. Yi Yu
  8. Qiuji Wu
  9. Yahua Zhong
  10. Melvin L.K. Chua
  11. Conghua Xie

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Abstract

Background

At present, there is a global pandemic of coronavirus disease 2019 (COVID-19) pneumonia. For COVID-19 patients, cancer is a coexisting disease that should not be Here, we conducted a multicenter retrospective study to show the clinical information and outcomes of cancer patients infected with COVID-19.

Measurements

Medical records of COVID-19 patients with cancer admitted to hospitals from Jan 5, 2020 to Feb 18, 2020 were collected.

Results

Of the 67 patients (median age: 66 years), the median age of patients with severe illness was older than that of patients with mild symptoms ( P <0.001). The proportion of severe patients had co-morbidities was higher than patients with mild disease ( P =0.004). During the treatment of COVID-19 pneumonia, tumor progression and recurrence was not observed for those patients still at the anticancer treatment phase. Lymphocytopenia was the main laboratory finding accompanying increased C-reactive protein and procalcitonin in cancer patients, especially in severe cases. By Mar 10, 2020, 18 (26.9%) patients died from COVID-19. The median age of survivors was younger than that of deaths ( P =0.014). Lung cancer (n=15, 22.4%) was the most common cancer type and accounted for the highest proportion COVID-19 resulted deaths (33.3%, 5/15). We observed a tendency that patients at the follow-up phase had a better prognosis than that at anticancer treatment phase ( P =0.095).

Conclusion

This study showed COVID-19 patients with cancer seem to have a higher proportion of severe cases and poorer prognosis. We should pay more intensive attentions to cancer patients infected with COVID-19.

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  1. ScreenIT

    SciScore for 10.1101/2020.03.21.20037127: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the ethics commissions of Zhongnan Hospital of Wuhan University, with a waiver of informed consent due to a public health outbreak investigation. Definitions: COVID-19 were diagnosed by real-time reverse transcription polymerase chain reaction assay for SARS-CoV-2 according to recommended protocol.
    Consent: This study was approved by the ethics commissions of Zhongnan Hospital of Wuhan University, with a waiver of informed consent due to a public health outbreak investigation. Definitions: COVID-19 were diagnosed by real-time reverse transcription polymerase chain reaction assay for SARS-CoV-2 according to recommended protocol.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical analyses were performed using IBM SPSS statistics (version 23.0 for Windows).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has several limitations. First, this is a retrospective study with only 67 cases from four hospitals. Although it is the largest cancer patient cohort of COVID-19 up to now. The results may not be representative of the entire cancer patient population and should be interpreted with caution. Second, some specific clinical information was insufficient and whether COVID-19 had further influence on the therapy and prognosis for cancer patients was not analysed in this study. Therefore, an extended follow-up should be recommended for these patients. In the future, a larger COVID-19 cancer patient cohort from multicenter is needed to explore more detail information of cancer patients.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.03.21.20037127v2 on medRxiv
  3. Version published to 10.1101/2020.03.21.20037127v1 on medRxiv