ArticleThe Lancet. Oncology2020
Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study.
Article in The Lancet. Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 337 papers, 12 of them syntheses that pooled it.
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Who cites it
337 citing papers in PubMed, 12 syntheses or guidelines pooled it.
- Seroconversion rate after COVID-19 vaccination in patients with solid cancer: A systematic review and meta-analysis.Human vaccines & immunotherapeutics · 2022Pooled it
- Are patients with cancer at higher risk of COVID-19-related death? A systematic review and critical appraisal of the early evidence.Journal of cancer policy · 2022Pooled it
- A composite ranking of risk factors for COVID-19 time-to-event data from a Turkish cohort.Computational biology and chemistry · 2022Pooled it
- Differences in Outcomes and Factors Associated With Mortality Among Patients With SARS-CoV-2 Infection and Cancer Compared With Those Without Cancer: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Pooled it
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- Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis.Cancer immunology, immunotherapy : CII · 2022Pooled it
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- Does prior exposure to immune checkpoint inhibitors treatment affect incidence and mortality of COVID-19 among the cancer patients: The systematic review and meta-analysis.International immunopharmacology · 2021Pooled it
- Hyperthermia ablation combined with transarterial chemoembolization versus monotherapy for hepatocellular carcinoma: A systematic review and meta-analysis.Cancer medicine · 2021Pooled it
- D-dimer, disease severity, and deaths (3D-study) in patients with COVID-19: a systematic review and meta-analysis of 100 studies.Scientific reports · 2021Pooled it
- Mortality in adult patients with solid or hematological malignancies and SARS-CoV-2 infection with a specific focus on lung and breast cancers: A systematic review and meta-analysis.Critical reviews in oncology/hematology · 2021Pooled it
- Meplazumab in hospitalized adults with severe COVID-19 (DEFLECT): a multicenter, seamless phase 2/3, randomized, third-party double-blind clinical trial.Signal transduction and targeted therapy · 2023Trial
- Upregulation of CCR4 in activated CD8European journal of immunology · 2021Trial
- Co-managing the double burden: strategies for simultaneously tackling infectious and non-communicable diseases.Infectious diseases of poverty · 2026Article
- Serum Albumin, Globulin and Albumin-Globulin Ratios as Biomarkers of Clinical Outcomes in COVID-19 Pneumonia.Journal of personalized medicine · 2026Article
- SARS-CoV-2 infection and its effects on toxicity and survival in non-metastatic nasopharyngeal carcinoma: a matched cohort study.BMC cancer · 2026Article
- Clinical Course and Risk Factors Affecting Mortality in Patients with Solid Organ Malignancies and COVID-19 Infection: A Retrospective Case-Control Study.Infectious diseases & clinical microbiology · 2026Article
- COVID-19 vaccine effectiveness in patients with lung cancer: challenges in the Omicron era.BMC infectious diseases · 2026Article
- A multicenter, observational study to evaluate the safety of restarting antitumor therapy recovered from COVID-19.Future oncology (London, England) · 2026Observational
277 more citing papers are in PubMed but not listed here.
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33 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCOVID-19 has spread globally. Epidemiological susceptibility to COVID-19 has been reported in patients with cancer. We aimed to systematically characterise clinical features and determine risk factors of COVID-19 disease severity for patients with cancer and COVID-19.
methodsIn this multicentre, retrospective, cohort study, we included all adult patients (aged ≥18 years) with any type of malignant solid tumours and haematological malignancy who were admitted to nine hospitals in Wuhan, China, with laboratory-confirmed COVID-19 between Jan 13 and March 18, 2020. Enrolled patients were statistically matched (2:1) with patients admitted with COVID-19 who did not have cancer with propensity score on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, illness severity, and clinical interventions were compared between patients with COVID-19 with or without cancer as well as between patients with cancer with non-severe or severe COVID-19. COVID-19 disease severity was defined on admission on the basis of the WHO guidelines. Univariable and multivariable logistic regression, adjusted for age, sex, comorbidities, cancer type, tumour stage, and antitumour treatments, were used to explore risk factors associated with COVID-19 disease severity. This study was registered in the Chinese Clinical Trial Register, ChiCTR2000030807.
findingsBetween Jan 13 and March 18, 2020, 13 077 patients with COVID-19 were admitted to the nine hospitals in Wuhan and 232 patients with cancer and 519 statistically matched patients without cancer were enrolled. Median follow-up was 29 days (IQR 22-38) in patients with cancer and 27 days (20-35) in patients without cancer. Patients with cancer were more likely to have severe COVID-19 than patients without cancer (148 [64%] of 232 vs 166 [32%] of 519; odds ratio [OR] 3·61 [95% CI 2·59-5·04]; p<0·0001). Risk factors previously reported in patients without cancer, such as older age; elevated interleukin 6, procalcitonin, and D-dimer; and reduced lymphocytes were validated in patients with cancer. We also identified advanced tumour stage (OR 2·60, 95% CI 1·05-6·43; p=0·039), elevated tumour necrosis factor α (1·22, 1·01-1·47; p=0·037), elevated N-terminal pro-B-type natriuretic peptide (1·65, 1·03-2·78; p=0·032), reduced CD4+ T cells (0·84, 0·71-0·98; p=0·031), and reduced albumin-globulin ratio (0·12, 0·02-0·77; p=0·024) as risk factors of COVID-19 severity in patients with cancer.
interpretationPatients with cancer and COVID-19 were more likely to deteriorate into severe illness than those without cancer. The risk factors identified here could be helpful for early clinical surveillance of disease progression in patients with cancer who present with COVID-19.
fundingChina National Natural Science Foundation.
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