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Cancer has an Independent Association with Death in Hospitalized Patients with COVID-19: A Single-center Study in Iran

Background: COVID-19 could cause severe complications in those with pre-existing conditions such as cancer. Here, we aimed to assess the outcome of COVID-19 in hospitalized patients with a history of cancer. 
Methods: In this retrospective cohort study, we extracted medical records of patients with any cancer history among hospitalized patients with COVID-19. Our patients were admitted between February 20th and July 15th, 2020. The primary outcome was death, and the secondary outcomes were overall survival, COVID-19-specific mortality, admission to intensive care unit (ICU), and hospital stay. A group of individuals without cancer history was selected from the COVID-19 cohort and matched for age, gender, and pre-existing conditions. We utilized univariate and multivariate logistic regression to analyze the association between studied variables and primary outcomes. 
Results: We identified 46 patients with cancer and COVID-19. The median age was 63, and 54.3% were male. According to the univariate logistic regression analysis, death was 5.3 (CI95%: 1.75-15.85) times more probable in cancer patients than controls (p=0.003). The multivariate analysis adjusted for having cancer and sex, age, and having any comorbidity showing this figure was 5.5 (CI95%:1.8-16.8) (p=0.003). The 30- and 90-day COVID-19 specific mortality was 30% (CI95%:17-43) and 33% (CI95%: 20-46), respectively. 
Conclusion: Patients with COVID-19 with a history of cancer have a considerably higher risk of death irrespective of age, gender, and other pre-existing conditions. Patients with advanced cancers and concurrent bacterial infections need the most vigorous care.