Increased risk of COVID-19-related admissions in patients with active solid organ cancer in the West Midlands region of the UK: a retrospective cohort study.

Akingboye, Akinfemi, Mahmood, Fahad, Amiruddin, Nabeel, Reay, Michael, Nightingale, Peter and Ogunwobi, Olorunseun O (2021) Increased risk of COVID-19-related admissions in patients with active solid organ cancer in the West Midlands region of the UK: a retrospective cohort study. BMJ open, 11 (12). e053352. ISSN 2044-6055. This article is available to all UHB staff and students login using a UHB Athens Account. Register for Athens here - https://openathens.nice.org.uk/

Full text not available from this repository.
Official URL: http://bmjopen.bmj.com/

Abstract

OBJECTIVE

Susceptibility of patients with cancer to COVID-19 pneumonitis has been variable. We aim to quantify the risk of hospitalisation in patients with active cancer and use a machine learning algorithm (MLA) and traditional statistics to predict clinical outcomes and mortality.

DESIGN

Retrospective cohort study.

SETTING

A single UK district general hospital.

PARTICIPANTS

Data on total hospital admissions between March 2018 and June 2020, all active cancer diagnoses between March 2019 and June 2020 and clinical parameters of COVID-19-positive admissions between March 2020 and June 2020 were collected. 526 COVID-19 admissions without an active cancer diagnosis were compared with 87 COVID-19 admissions with an active cancer diagnosis.

PRIMARY AND SECONDARY OUTCOME MEASURES

30-day and 90-day post-COVID-19 survival.

RESULTS

In total, 613 patients were enrolled with male to female ratio of 1:6 and median age of 77 years. The estimated infection rate of COVID-19 was 87 of 22 729 (0.4%) in the patients with cancer and 526 of 404 379 (0.1%) in the population without cancer (OR of being hospitalised with COVID-19 if having cancer is 2.942671 (95% CI: 2.344522 to 3.693425); p<0.001). Survival was reduced in patients with cancer with COVID-19 at 90 days. R-Studio software determined the association between cancer status, COVID-19 and 90-day survival against variables using MLA. Multivariate analysis showed increases in age (OR 1.039 (95% CI: 1.020 to 1.057), p<0.001), urea (OR 1.005 (95% CI: 1.002 to 1.007), p<0.001) and C reactive protein (CRP) (OR 1.065 (95% CI: 1.016 to 1.116), p<0.008) are associated with greater 30-day and 90-day mortality. The MLA model examined the contribution of predictive variables for 90-day survival (area under the curve: 0.749); with transplant patients, age, male gender and diabetes mellitus being predictors of greater mortality.

CONCLUSIONS

Active cancer diagnosis has a threefold increase in risk of hospitalisation with COVID-19. Increased age, urea and CRP predict mortality in patients with cancer. MLA complements traditional statistical analysis in identifying prognostic variables for outcomes of COVID-19 infection in patients with cancer. This study provides proof of concept for MLA in risk prediction for COVID-19 in patients with cancer and should inform a redesign of cancer services to ensure safe delivery of cancer care.

Item Type: Article
Additional Information: This article is available to all UHB staff and students login using a UHB Athens Account. Register for Athens here - https://openathens.nice.org.uk/
Subjects: QT Human physiology
WB Practice of medicine
WLM Psychology
Related URLs:
Depositing User: Lotty Summers
Date Deposited: 22 Dec 2021 16:33
Last Modified: 22 Dec 2021 16:33
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4963

Actions (login required)

View Item View Item