Factors Associated with Deaths in Hospitalized Cancer Patients and COVID-19 in an Amazon Region: a Cross-sectional Study with Data from Epidemiological Surveillance
Daniele Melo Sardinha *
Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará e Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém, Pará, Brazil.
Rebecca Lobato Marinho
Bolsista de Iniciação Científica, Instituto Evandro Chagas (IEC), Ananindeua, Pará Brazil.
Juliane Lima Alencar
Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua, Pará, Brazil.
Marina Pereira Queiroz dos Santos
Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua, Pará, Brazil.
Rosane do Nascimento Rodrigues
Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Belém, Pará, Brazil.
Paulo Henrique Viana da Silva
Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Belém, Pará, Brazil.
Lucas Vinícius Moraes da Silva
Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Belém, Pará, Brazil.
Diana da Costa Lobato
Secretaria de Saúde Pública do Estado do Pará (SESPA), Belém, Pará, Brazil.
Milena Farah Damous Castanho Ferreira
Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Belém, Pará, Brazil.
Natasha Cristina Oliveira Andrade
Universidade da Amazônia (UNAMA), Belém, Pará, Brazil.
Tamires de Nazaré Soares
Universidade da Amazônia (UNAMA), Belém, Pará, Brazil.
Juliana Conceição Dias Garcez
Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará e Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém, Pará, Brazil.
Ana Lúcia da Silva Ferreira
Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará e Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém, Pará, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: The COVID-19 pandemic has already affected Brazil dramatically, but the northern region of the country has suffered greater impacts due to regional vulnerability factors.
Objective: To describe the factors associated with deaths in hospitalized cancer patients and COVID-19 in the state of Pará, Brazil.
Methods: Cross-sectional study with data from epidemiological surveillance of acute and severe respiratory syndromes of hospitalized cases notified from January 1, 2020, to December 31, 2020. Clinical and outcome variables, chi-square test, and Odds ratio were analyzed.
Results: 164 cases, lethality represented 94 (57.32%). The mean overall age was 63 years, of survivors was 60 years and of deaths was 66 years. Advanced age was associated with deaths (p-0.039). Male gender was associated with deaths (65.96% - p- 0.006 - OR 2,438 - CI 1,291-4,604). Similarly, the signs and symptoms associated with death were dyspnea (80.85% - p- 0.028 - OR 2,203 - CI 1,080-4,491), respiratory distress (76.60% - p- 0.003 - OR 2,756 - CI 1,410-5,387), O2 saturation <95% represented almost four times to the chances of death (68.09% - p-<0.001 - OR 3,398 - CI 1,798-6,494). Comorbidities were not associated with deaths, however, Immunodeficiency/Immunodepression represented the most frequent in the cases (22.56%), followed by Chronic Cardiovascular Disease (21.95%) and Diabetes Mellitus (18.90%). ICU admission was associated with deaths with the highest odds ratio of the analysis almost five times (42.55% - p- <0.001 - OR 4,444 - CI 2,028-9,739).
Conclusion: In this study, we showed that the lethality was higher than in other studies of hospitalized cancer patients with COVID-19, as well as higher than the overall lethality of COVID-19 among hospitalized patients. The factors associated with deaths are similar to those in the literature, except that immunodeficiency is a specific condition in cancer patients and is associated with an unfavorable outcome.
Keywords: Oncology, cancer, neoplasm, severe acute respiratory syndrome, COVID-19