Table 4.

Factors Associated with In-Hospital Mortality in Patients with Cancer Who Were Hospitalized with COVID-19

Variable	Univariate Model: Unadjusted OR (95% CI)	p Value	Multivariate Model: Adjusted OR (95% CI)	p Value
Admission Viral Loada,b
Low (cobas, CT value > 30; Xpert Xpress, CT value > 32)	Reference		Reference
Medium (cobas, CT value 25–30; Xpert Xpress, CT value 27–32)	2.82 (0.72–11.01)	0.14	2.13 (0.51–8.85)	0.30
High (cobas, CT value < 25; Xpert Xpress, CT value < 27)	5.99 (1.79–20.07)	0.004	5.00 (1.42–17.61)	0.012
Type of Active Cancer
Solid tumor	Reference
Hematologic malignancy	1.00 (0.42–2.39)	1.00
Chemotherapy within previous 6 months	1.56 (0.64–3.79)	0.33
Demographics
Age, per year increase	1.06 (1.01–1.10)	0.011	1.05 (1.00–1.10)	0.037
Femalec	0.45 (0.18–1.09)	0.08
Race/ethnicity
White (non-Hispanic)	Reference
Black (non-Hispanic)	0.87 (0.20–3.76)	0.86
Asian (non-Hispanic)	2.80 (0.81–9.66)	0.10
Hispanic	1.71 (0.56–6.20)	0.35
Other or missing	1.6 (0.25–10.07)	0.62
Comorbiditiesd
Obesity (BMI > 30)c	2.38 (0.94–6.01)	0.07
Coronary artery diseasec	2.31 (0.90–5.96)	0.08
Congestive heart failurec	2.74 (0.87–8.66)	0.09
Diabetes mellitus	1.26 (0.51–3.10)	0.61
Hypertension	0.93 (0.39–2.18)	0.86
Chronic pulmonary disease	1.59 (0.58–4.37)	0.37
Chronic kidney disease	2.54 (0.59–10.91)	0.21
Social Characteristicsd
Active or former smoker	1.17 (0.47–2.91)	0.74
Known exposure to COVID-positive patient	1.69 (0.54–5.28)	0.36
Nursing home/rehabilitation facility residentc	3.27 (1.06–10.08)	0.039
Symptoms
Fever	0.91 (0.39–2.14)	0.83
Cough	1.19 (0.50–2.84)	0.69
Dyspnea	0.75 (0.32–1.77)	0.51
Duration of symptoms, per day increase	1.00 (0.92–1.09)	0.96
ED Presentation
Need for supplemental oxygen within 3 h of ED presentation	3.97 (1.36–11.58)	0.011	3.16 (1.02–9.82)	0.047
Laboratory findingse
Leukocytosis: WBC > 11 × 109 cells/L	1.19 (0.40–3.53)	0.76
Lymphopenia: ALC < 1 × 109 cells/L	0.83 (0.34–2.02)	0.69
AST elevation	1.12 (0.57–2.66)	0.80
ALT elevation	0.43 (0.11–1.62)	0.21
Chest X-ray results
No infiltrates	Reference
Unilateral infiltrates	0.63 (0.11–3.80)	0.62
Bilateral infiltrates	2.24 (0.74–6.81)	0.16
Relationship to apex of COVID-19 in New York Cityc
Pre-apex (March 15–29)	3.20 (0.83–12.35)	0.09
Apex (March 30–April 8)	Reference
Post-apex (April 9–May 14)	0.53 (0.20–1.44)	0.21
Hospitalc
Hospital no. 1	Reference
Hospital no. 2	0.33 (0.13–0.86)	0.023
Hospital no. 3	0.40 (0.11–1.50)	0.18

Bold p values indicate those that meet statistical significance.

Abbreviations: ALC, absolute lymphocyte count; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; CI, confidence interval; cobas, cobas SARS-CoV-2 assay; C_T, cycle threshold; ED, emergency department; OR, odds ratio; WBC, white blood cell count; Xpert Xpress, Xpert Xpress SARS-CoV-2 assay.

^aC_T values based on SARS-CoV-2-specific targets (cobas, ORF1ab gene; Xpert Xpress, N2 gene).

^bIn a sensitivity analysis that applies the cobas C_T value viral load cutoffs (high, C_T < 25; medium, C_T < 25–30; low, C_T > 30) to both the cobas and Xpert Xpress assays, having a high viral load was also independently associated with in-hospital mortality (aOR = 4.71; 95% CI, 1.44–15.44; p = 0.01) compared with having a low viral load.

^cRemoved from final model because p value ≥ 0.1 in multivariate analysis.

^dOnly comorbidities or social characteristics that were present in ≥5 patients with active cancer were considered for analysis.

^eOnly laboratory findings that were available in ≥90% of patients were considered in this model.