Lei Nie1, Kai Dai2, Jiang Wu3, Xia Zhou4, Junjun Hu5, Chao Zhang6, Yan Zhan7, Yu Song8, Wen Fan9, Zhimin Hu10, Hongshan Yang11, Qiong Yang12, Dongde Wu1, Fajiu Li13, Daoyuan Li14, Rui Nie15. 1. Department of Hepatobiliary and Pancreatic Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 2. Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, China. 3. Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China. 4. Department of Respiratory and Critical Care Medicine, Wuhan Jinyintan Hospital, Wuhan, China. 5. Department of Surgery, Wuhan NO. 7 Hospital, Wuhan, China. 6. Department of Hepatobiliary Surgery, Wuhan NO.1 hospital, Wuhan, China. 7. Department of rehabilitation medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China. 8. Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Wuhan, China. 9. Department of General Medicine, The First People's Hospital of Jingzhou Affiliated No. 1 Hospital of Changjiang University, Jingzhou, China. 10. Endoscopy Center, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, China. 11. Department of Medical Oncology, Affiliated Xiaogan Hospital of Wuhan University of Science and Technology, Xiaogan, China. 12. Department of Obstetrics, Hubei Maternal and Child Health Hospital, Wuhan, China. 13. Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China. 14. Department of Art and Design, Hubei University of Technology Engineering and Technology College, Wuhan, China. 15. Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Abstract
BACKGROUND: Data on clinical, laboratory, and radiographic characteristics and risk factors for in-hospital mortality of lung cancer patients with COVID-19 are scarce. Here, we aimed to characterize the early clinical features of lung cancer patients with COVID-19 and identify risk factors associated with in-hospital mortality. METHODS: All consecutive lung cancer patients with laboratory-confirmed COVID-19 admitted to 12 hospitals in Hubei province, China, from 3 January to 6 May 2020 were included in the study. Patients without definite clinical outcomes during the period were excluded. Data on initial clinical, laboratory and radiographic findings were compared between survivors and nonsurvivors. Univariable and multivariable logistic regression analyses were used to explore the risk factors associated with in-hospital mortality. RESULTS: Of the 45 lung cancer patients (median [interquartile range] age, 66 [58-74] years; 68.9% males) included, 34 (75.6%) discharged and 11 (24.4%) died. Fever (73.3%) and cough (53.3%) were the dominant initial symptoms, and respiratory symptoms were common. Lung cancer patients also presented atypical appearances of COVID-19. In the multivariable analysis, prolonged prolongation prothrombin time (PT) (OR = 2.1, 95% CI: 1.00-4.41, P = 0.0497) and elevated high sensitivity cardiac troponin I (hs-TNI) (OR = 7.65, 95% CI: 1.24-47.39, P = 0.0287) were associated with an increased risk of in-hospital mortality. CONCLUSIONS: Lung cancer patients with COVID-19 have high in-hospital mortality. Prolonged PT and elevated hs-TNI are independent risk factors for in-hospital mortality of lung cancer patients with COVID-19. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Lung cancer patients with COVID-19 have atypical early symptoms and imaging features. The prolonged prothrombin time and elevated high sensitivity cardiac troponin I are independent risk factors for in-hospital mortality of lung cancer patients with COVID-19. WHAT THIS STUDY ADDS: This study characterizes the early clinical features of lung cancer patients with COVID-19 in China, and identifies the risk factors associated with in-hospital mortality of lung cancer patients with COVID-19.
BACKGROUND: Data on clinical, laboratory, and radiographic characteristics and risk factors for in-hospital mortality of lung cancerpatients with COVID-19 are scarce. Here, we aimed to characterize the early clinical features of lung cancerpatients with COVID-19 and identify risk factors associated with in-hospital mortality. METHODS: All consecutive lung cancerpatients with laboratory-confirmed COVID-19 admitted to 12 hospitals in Hubei province, China, from 3 January to 6 May 2020 were included in the study. Patients without definite clinical outcomes during the period were excluded. Data on initial clinical, laboratory and radiographic findings were compared between survivors and nonsurvivors. Univariable and multivariable logistic regression analyses were used to explore the risk factors associated with in-hospital mortality. RESULTS: Of the 45 lung cancerpatients (median [interquartile range] age, 66 [58-74] years; 68.9% males) included, 34 (75.6%) discharged and 11 (24.4%) died. Fever (73.3%) and cough (53.3%) were the dominant initial symptoms, and respiratory symptoms were common. Lung cancerpatients also presented atypical appearances of COVID-19. In the multivariable analysis, prolonged prolongation prothrombin time (PT) (OR = 2.1, 95% CI: 1.00-4.41, P = 0.0497) and elevated high sensitivity cardiac troponin I (hs-TNI) (OR = 7.65, 95% CI: 1.24-47.39, P = 0.0287) were associated with an increased risk of in-hospital mortality. CONCLUSIONS:Lung cancerpatients with COVID-19 have high in-hospital mortality. Prolonged PT and elevated hs-TNI are independent risk factors for in-hospital mortality of lung cancerpatients with COVID-19. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Lung cancerpatients with COVID-19 have atypical early symptoms and imaging features. The prolonged prothrombin time and elevated high sensitivity cardiac troponin I are independent risk factors for in-hospital mortality of lung cancerpatients with COVID-19. WHAT THIS STUDY ADDS: This study characterizes the early clinical features of lung cancerpatients with COVID-19 in China, and identifies the risk factors associated with in-hospital mortality of lung cancerpatients with COVID-19.