Published online May 24, 2022. doi: 10.5306/wjco.v13.i5.339
Peer-review started: October 3, 2021
First decision: November 19, 2021
Revised: November 30, 2021
Accepted: April 25, 2022
Article in press: April 25, 2022
Published online: May 24, 2022
Processing time: 233 Days and 2 Hours
The lack of correlation data between coronavirus disease 2019 (COVID-19) and Solid malignancy limits the understanding of the true mortality impact of the COVID-19 in the Indian settings.
Higher incidence of serious clinical events and intensive care unit (ICU) admissions in cancer patients. Analysis suggests patients have increased morbidity and mortality from recent cytotoxic chemotherapy. Patients with active untreated cancer, metastatic disease, progressive disease with multiple co-morbidity and getting palliative treatment are at a higher risk of mortality.
The primary objectives of the study include COVID-19 related mortality outcomes within 30 d of diagnosis with HRCT score and RT-PCR Ct value-based viral load in various solid malignancies.
This is a single-center, retrospective study conducted at a tertiary cancer care hospital including confirmed COVID-19 in a diagnosed case of solid malignancy. The primary endpoint was to measure mortality within 30 d of diagnosis of COVID-19 with HRCT score and RT-PCR Ct value-based viral load.
The risk of death was statistically significant with the presence of symptomatic presentation, number of comorbidities ≥ 2 vs none, Eastern Cooperative Oncology Group performance status of 0/1 v/s ≥ 2. The odds ratio of mortality were significantly higher in patients presented with moderate and severe HRCT scores as compared to patients with mild HRCT scores. No statistically significant association of 30-d mortality was found concerning age, sex, type of malignancy, type of anticancer therapy, obesity status, recent surgery and active cancer (progressing vs remission). Also, no significant effect on mortality was noted for the patients with RT PCR based on different viral load levels.
Mortality rates are higher in patients with high baseline HRCT values at presentation and who need longer ICU stays. Mortality rates are not higher in older cancer patients as compared to younger counterparts with cancer. Mortality rates are not statistically significant in co-relation with high baseline RT-PCR based viral load values at presentation.
If there are further COVID-19 outbreaks, the findings of these studies will be helpful for clinical practice to categorize the patients on the basis of various demographic and clinical parameters for prognostication of patients.