Prognostic factors in patients with advanced cancer and COVID-19: a cohort from the Palliative Care Unit of the Brazilian National Cancer Institute

Abstract

Objective: To describe overall survival (OS) in 90 days and to evaluate the prognostic factors in patients with advanced cancer and COVID-19. Methods: This is a retrospective cohort study carried out at the Palliative Care Unit of the Brazilian National Cancer Institute. Patients with advanced cancer and COVID-19 confirmed by Reverse Transcription Polymerase Chain Reaction were included. Kaplan-Meier’s curves, log-rank test, and Cox regression were performed. Results: Eighty-three inpatients were selected. The average age was 61.4 (±12.6) years, with a higher proportion of women (73.4%). The most prevalent tumor type was breast (36.7%), followed by gastrointestinal tract (20.3%). The OS was 32 [interquartile range (IQR): 6–70] days, and at the end of the follow-up period, 17 patients (20.5%) were alive and 66 (79.5%) had died. Patients with advanced cancer and COVID-19 and who were 60–74 years old [hazard ratio (HR): 2.03; 95% confidence interval (CI): 1.09–3.78], with lung tumors (HR: 17.50; 95% CI: 1.70–28.34), with lung metastasis (HR: 4.21; 95% CI: 2.17–8.15), and with chronic obstructive pulmonary disease (HR: 4.92; 95% CI: 1.01–24.69) had higher risk of death in 90 days. Conclusion: The age of 60–74 years old, lung tumors (primary or metastases), and the presence of chronic obstructive pulmonary disease were considered independent prognostic factors in patients with advanced cancer and COVID-19.