Factor Associated with Mortality of Hospitalized Cancer Patients with COVID-19 Infection in Indonesia National Cancer Center

Sri Agustini Kurniawati, Noorwati Sutandyo, Hilman Tadjoedin, Jaka Pradipta, Ratu Ralna Ismuha, Citra Dovina Khaira Ummah, Kresna Dharma Suryana, Erwin Budi

Abstract


Background: Cancer patients with COVID-19 are at risk of developing severe complications and outcomes due to immunosuppressive and inflammatory states. This study aims to provide insight into risk factors associated with mortality in this population.

 

Methods: A retrospective cohort study was conducted at Dharmais National Cancer Center, Jakarta, Indonesia, from May 2020 to July 2021. Data were collected through electronic medical records using the consecutive sampling technique. The numerical and categorical data were then tested statistically.

 

Results: The results showed 180 cancer patients with COVID-19 were hospitalized at Dharmais National Cancer Center. Among the patients, 114 patients survived, and 66 patients deceased. Across all risk factors analyzed to mortality, patients with Diabetes Mellitus (OR 0.41;0.22-0.77, p-value <0.05) and high level of D-dimer (OR 2.00;1.06-3.79, P-value <0.05) have a higher risk in mortality. The Results showed that survived patients have lower D-dimer levels (2010 ng/L) and deceased patients have higher D-dimer levels (3264 ng/L) with P-value < 0.05.

 

Conclusion: High D-dimer levels and diabetes are risk factors significantly associated with mortality in hospitalized cancer patients with COVID-19 Infection.


Keywords


cancer, COVID-19, DM, D-dimer, mortality, risk factors

Full Text: View | Download

DOI: 10.33371/ijoc.v18i2.1077

Article Metrics

Abstract View: 271,
PDF Download: 148
             

References


Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506.

Yabroff KR, Wu XC, Negoita S, et al. Association of the COVID-19 Pandemic With Patterns of Statewide Cancer Services. J Natl Cancer Inst. 2022 Jun 13;114(6):907-909.

Jiang C, Yabroff KR, Deng L, et al. Prevalence of underlying medical conditions associated with severe COVID-19 illness in adult cancer survivors in the United States. J Natl Cancer Inst. 2022;114(1):156-159.

Grivas P, Khaki AR, Wise-Draper TM, et al. Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Ann Oncol. 2021 Jun;32(6):787-800.

Shi W, Lv J, Lin L. Coagulopathy in COVID-19: Focus on vascular thrombotic events. J Mol Cell Cardiol. 2020 Sep;146:32.

Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar;21(3):335-337

Savvari P. Cancer-associated thromboembolism: could direct-acting oral anticoagulants be a promising therapeutic option? Literature review. Forum of Clinical Oncology. 2020;11:22–8.

Pan S, Jiang J, Chen Z, Yang L. Management and thinking on the treatment of cancer patients during the COVID-19. Front Mol Biosci. 2020;8.

Guidelines Review Committee. Therapeutics and COVID-19: living guideline [Internet]. World Health Organization; 2022 [cited 2022 May 3]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2022.

Mucha SR, Dugar S, McCrae K, et al. Update to coagulopathy in COVID-19: Manifestations and management. Cleve Clin J Med. 2021 Jun 2.

Yang K, Sheng Y, Huang C, et al. Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. Lancet Oncol. 2020 Jul;21(7):904-913.

Sorouri M, Kasaeian A, Mojtabavi H, et al. Clinical characteristics, outcomes, and risk factors for mortality in hospitalized patients with COVID-19 and cancer history: a propensity score-matched study. Infect Agent Cancer. 2020 Dec 17;15(1):74.

Guidelines Review Committee. Therapeutics and COVID-19: living guideline [Internet]. World Health Organization; 2022 [cited 2022 May 3]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2022.3

Abuhelwa Z, Alsughayer A, Abuhelwa AY, et al. In-hospital mortality and morbidity in cancer patients with COVID-19: a nationwide analysis from the United States. Cancers. 2022 Dec 30;15(1):222.

Kim SS, Kim HS. The impact of the association between cancer and diabetes mellitus on mortality. J Pers Med. 2022; 12(7):1099.

Ranc K, Jørgensen ME, Friis S. Mortality after cancer among patients with diabetes mellitus: effect of diabetes duration and treatment. Diabetologia. 2014; 57:927–934.

Kulcsar KA, Coleman CM, Beck SE, Frieman MB. Comorbid diabetes results in immune dysregulation and enhanced disease severity following MERS-CoV infection. JCI Insight. 2019 Oct 17;4(20):e131774.

Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020 Jun 6;395(10239):1763-1770.

Mangalmurti N, Hunter CA. Cytokine Storms: Understanding COVID-19. Immunity. 2020 Jul 14;53(1):19–25.

da Silva JL, de Souza BSW, de Albuquerque LZ, et al. Factors influencing COVID-19 mortality among cancer patients: A Brazilian multi-institutional study. PLoS One. 2023 Dec 21;18(12):e0295597.

Mehta V, Goel S, Kabarriti R, et al. Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discov. 2020 Jul; 10(7):935– 41.

Dai M, Liu D, Liu M, et al. Patients with Cancer Appear More Vulnerable to SARS- CoV-2: A Multicenter Study during the COVID-19 Outbreak. Cancer Discov. 2020 Jun; 10(6):783–91.

Lee LYW, Cazier JB, Starkey T, et al. COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol. 2020 Oct;21(10):1309–16.

Iba T, Levy JH, Connors JM, et al. The unique characteristics of COVID-19 coagulopathy. Crit Care. 2020 Jun 18;24(1):360.

Xiong B, Liu T, Luo P, et al. Prominent Hypercoagulability Associated With Inflammatory State Among Cancer Patients With SARS-CoV-2 Infection. Front Oncol. 2020 Jul 16;10:1345.

Elgohary G. COVID-19 infection in cancer patients: a systematic review and meta-analysis with emphasizing the risk and prognosis stratification. Hematol Transfus Cell Ther. 2020 Oct;42:24–5.

Sukrisman L, Sinto R. Coagulation profile and correlation between D-dimer, inflammatory markers, and COVID-19 severity in an Indonesian national referral hospital. J Int Med Res. 2021 Nov;49(11):3000605211059939.

Zhan H, Chen H, Liu C, et al. Diagnostic Value of D-Dimer in COVID-19: A Meta-Analysis and Meta-Regression. Clin Appl Thromb Hemost. 2021 Jan;27:10760296211010976.

Li Y, Deng Y, Ye L, et al. Clinical Significance of Plasma D-Dimer in COVID-19 Mortality. Front Med. 2021 May 25;8:638097.

Patell R, Bogue T, Bindal P, et al. Incidence of thrombosis and hemorrhage in hospitalized cancer patients with COVID-19. J Thromb Haemost. 2020 Sep;18(9):2349–57.

Li A, Kuderer NM, Warner JL, et al. Incidence of and Risk Factors for Venous Thromboembolism Among Hospitalized Patients with Cancer and COVID-19: Report from the COVID-19 and Cancer Consortium (CCC19) Registry. Blood. 2020;136(Supplement 1):56-58.

Salunke AA, Nandy K, Pathak SK, et al. Impact of COVID -19 in cancer patients on severity of disease and fatal outcomes: A systematic review and meta-analysis. Diabetes Metab Syndr. 2020 Sep;14(5):1431–7.

Wool GD, Miller JL. The Impact of COVID-19 Disease on Platelets and Coagulation. Pathobiology. 2021;88(1):15–27.

Zhou X, Cheng Z, Luo L, et al. Incidence and impact of disseminated intravascular coagulation in COVID-19 a systematic review and meta-analysis. Thromb Res. 2021 May;201:23–9.

Horowitz NA, Brenner B. Thrombosis and Hemostasis Issues in Cancer Patients with COVID-19. Semin Thromb Hemost. 2020 Oct;46(7):785–8.

Han MA, Hwang EC, Jung JH. Prognostic factors of mortality in patients with cancer infected with COVID-19: a systematic review protocolBMJ Open 2023;13:e071810.

Kollias A, Kyriakoulis KG, Dimakakos E, et al. Thromboembolic risk and anticoagulant therapy in COVID-19 patients: emerging evidence and call for action. Br J Haematol. 2020 Jun;189(5):846–7.

Zavras PD, Mehta V, Goel S, Pradhan K, Billett HH. Increased Incidence of Thrombosis in a Cohort of Cancer Patients with COVID-19. Acta Haematol. 2022;145(2):152-159.

Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720.

Viana-Llamas MC, Arroyo-Espliguero R, Silva-Obregón JA, et al. Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study. Med Clin (Barc). 2021;156(9):428-436.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.