Clinical Course and Risk Factors Affecting Mortality in Patients with Solid Organ Malignancies and COVID-19...

Patients with solid organ malignancy (SOM) constitute a high-risk group during the COVID-19 pandemic. Current evidence suggests that this population is more likely to experience severe clinical outcomes, higher hospitalization rates, and increased mortality following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to investigate the clinical course of COVID-19 in patients with SOM and to determine its impact on mortality.

This retrospective case-control study included patients aged 18 years and older who tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). As a control group, patients without malignancy but with similar characteristics in terms of age, sex, comorbidities, and vaccination status were selected. Comparisons between the two groups were performed, and risk factors associated with mortality were analyzed.

A total of 580 patients with COVID-19 were included in the study, comprising 144 patients with SOM and 436 patients without SOM. Patients with SOM had significantly higher rates of hospital admission (p<0.001), secondary infections (p<0.001), critical illness (p<0.001), intensive care unit requirements (p<0.001), oxygen therapy (p=0.016), and corticosteroid use (p=0.028). In multivariate logistic regression analysis, age (odds ratio [OR]: 1.052), male sex (OR: 2.276), solid organ malignancy (OR: 3.809), C-reactive protein (CRP) >54.7 mg/L (OR: 2.671), procalcitonin >0.110 ng/mL (OR: 2.298), D-dimer >502.5 ng/mL (OR: 2.750), and lactate dehydrogenase (LDH) >412.5 U/L (OR: 2.682) were found to significantly increase the risk of mortality. Notably, the presence of solid organ malignancy was associated with approximately a 3.8-fold higher risk of death.

Patients with SOM carry a significantly increased risk of mortality during COVID-19 infection. In this patient group, careful evaluation of age, sex, inflammatory parameters, and biomarker levels is warranted. These findings underscore the importance of early identification of high-risk groups and the implementation of personalized treatment strategies in the management of COVID-19.

Graphic Abstract.