Epidemiologic and Clinical Characteristics of Cancer Patients Presented to the Emergency Service with COVID-19...

The study aimed to define the clinical characteristics of coronavirus disease (COVID-19) in cancer patients admitted to the emergency service (ES) and to determine the parameters associated with mortality.

The data of patients with COVID-19 symptoms and solid or hematological malignancies under anticancer treatment, who presented to the ES between March 1, 2020, and March 31, 2021, and underwent RT-PCR (Real-Time Polymerase Chain Reaction) testing, were evaluated. Demographic, clinical, and laboratory parameters were compared between COVID-19-negative and COVID-19-positive groups, as well as between survivor and non-survivor groups in COVID-19-positive patients. Parameters associated with poor prognosis and mortality were evaluated in patients with COVID-19.

The study was completed with 468 patients. The COVID-19 positivity ratio is 43.4%. The solid and hematologic malignancy ratios are 24.1% and 75.9%, respectively, in the positive group. Age, gender, comorbidities, cancer type, and stage, metastasis, and anticancer treatments are similar between the groups (p>0.05). Contact history (p<0.001), musculoskeletal pain (p = 0.015) are more frequent, and CRP (p<0.01), and lactate level (p<0.01) are significantly higher in the COVID-19 group. The mortality rate is 38.4% in the COVID-19-positive group. Most of the non-survivors are male patients with advanced age, solid organ malignancy with lung metastases, with poorer performance status, low blood pressure and oxygen saturation, tachycardia, and tachypnea (p<0.001). WBC, neutrophil, NLR, BUN, phosphorus, AST, GGT, LDH, troponin, fibrinogen, D-Dimer, INR, Ferritin, CRP, PRC, and lactate levels are significantly higher, while lymphocyte, calcium, total protein, and albumin levels are lower (p<0.05) in the non-survivor group. These parameters were identified as risk factors associated with a poor prognosis.

The availability of biomarkers that predict adverse clinical outcomes of COVID-19 disease in cancer patients may enable accurate and timely risk assessment, facilitating the early initiation of appropriate treatment.