Cancer, Mortality, and Acute Kidney Injury Among Hospitalized Patients
with SARS-CoV-2 Infection
Abstract
Background: To evaluate COVID19 patients treated within our academic
medical system to determine if history of malignancy, both in general
and specifically in genitourinary oncology patients, is associated with
adverse clinical outcomes, including AKI and mortality. Methods: We
conducted a retrospective cohort study among patients with confirmed
SARS-CoV-2 infection in a multi-hospital, academic medical institution
in New York City. Outcomes included mortality, ICU admission and AKI
among hospitalized patients. We also evaluated risk of hospitalization
among all patients with SARS-CoV-2 infection. Multilevel logistic
regression models were used for analysis. Results: We identified 6,893
patients who met inclusion criteria, of which 4,018 were hospitalized.
Among hospitalized patients 374 (9%) had a history of cancer, 281 (7%)
experienced AKI, and 1,045 (26%) died. In adjusted analyses, patients
with a history of cancer had 1.33 (95% CI = 1.05, 1.69) times the odds
of death compared to those without cancer and this appeared to be driven
by lung cancer (OR= 2.44, 95% CI= 1.05, 4.39). Patients with a history
of genitourinary cancer were not at higher risk of mortality compared to
those without cancer (OR=0.99, 95% CI= 0.61, 1.62). History of cancer
was not associated with ICU admission or AKI in overall and subgroup
analyses. Conclusions: Patients with a history of cancer who are
hospitalized with SARS-CoV-2 infection are not at greater risk for AKI,
though they are at higher risk for mortality as compared to patients
without a history of cancer. The increased risk in mortality appears
driven by patients with pulmonary neoplasms. Patients with a history of
genitourinary malignancies do not appear to be at higher risk for AKI or
for mortality compared to the general population.