Certain factors may increase the risk of severe COVID-19 in cancer patients, according to research presented at ASCO Breakthrough 2023.

Results from this single-center study suggested that high baseline neutrophil/lymphocyte ratio (NLR), liver disease, and hypertension are independently associated with severe COVID-19 in cancer patients.

The study included 213 patients who tested positive for SARS-CoV-2 infection by RT-PCR test or rapid antigen test at Sawanpracharak Hospital in Nakhon Sawan, Thailand, between October 2020 and April 2022.  

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A total of 20 patients (9.4%) developed severe COVID-19, which was defined as requiring either high-flow nasal cannula or a mechanical ventilator. The mortality rate was 6.5%.

Patients with severe COVID-19 were more likely than patients with non-severe COVID-19 to discontinue cancer treatment — 73.7% and 9.9%, respectively (P <.001).

Patients with severe COVID-19 were also more likely than patients with non-severe COVID-19 to experience disease progression — 82.4% and 25.3%, respectively (P =.001).

In a univariate analysis, several factors were significantly associated with severe COVID-19, including diarrhea, oxygen saturation less than 92%, ECOG performance status score of 2 or higher, use of best supportive care, diabetes mellitus, hypertension, liver disease, polypharmacy, fewer than 2 vaccinations, high NLR, high C-reactive protein level, and hospital-acquired pneumonia.  

In a multivariate analysis, the following factors were significant predictors of severe COVID-19: 

  • High NLR (odds ratio [OR], 46.787; 95% CI, 2.063-1061.227; P =.012)
  • Liver disease (OR, 26.885; 95% CI, 1.666-433.785; P =.020)
  • Hypertension (OR, 44.095; 95% CI, 1.082-1797.017; P =.045).

Cancer patients with these risk factors should be carefully monitored, according to study presenter Sunee Neesanun, MD, of Sawanpracharak Hospital.


Neesanun S. The prognostic factor of severe COVID-19 in cancer patients and outcomes. ASCO Breakthrough 2023. August 3-5, 2023. Abstract 162.

This article originally appeared on Cancer Therapy Advisor