Discharge outcomes in COVID and non-COVID cohorts of hospitalized patients with cancer: A comparative analysis in the first year of the COVID-19 pandemic.

person Bilja Kurian Sajith The University of Texas MD Anderson Cancer Center, Houston, TX info_outline Bilja Kurian Sajith, Sandra K. Cesario, Anecita P. Fadol, Joseph Nates

Authors person Bilja Kurian Sajith The University of Texas MD Anderson Cancer Center, Houston, TX info_outline Bilja Kurian Sajith, Sandra K. Cesario, Anecita P. Fadol, Joseph Nates Organizations The University of Texas MD Anderson Cancer Center, Houston, TX, Texas Woman’s University, Houston, TX Abstract Disclosures Research Funding No funding sources reported Background: This research aimed to assess and compare the discharge outcomes in two cohorts of hospitalized oncology patients – those with COVID-19 and those without COVID-19 in the initial year of COVID pandemic. Methods: This study compared the length of hospital stay, 30-day readmission, in-hospital mortality, death within 30 days of admission, and death within 90 days of admission between the COVID cohort and the non-COVID cohort, based on prospectively collected hospitalization data from March 2020 to February 2021 at a prominent US cancer center. Results: The study included 4,225 oncology patients, with 551 having COVID-19. Aged on average around 61, both cohorts showed similar gender distribution and were predominantly White or Caucasian, with the most common cancers being hematological. Patients in the COVID cohort experienced a significantly extended hospital stay with a mean length of 12.2 days versus 8.27 days for the non-COVID cohort (p < 0.001). The median stay was also longer for the COVID cohort at 8 days [1, 103] compared to 5 days [1, 141] for the non-COVID cohort. The COVID cohort had a lower 30-day readmission rate post-discharge at 66.6% compared to 71.7% in the non-COVID cohort, with the difference being statistically significant (p = 0.015). Within the COVID cohort, a smaller proportion of patients were readmitted within 30 days of discharge (66.6%), as opposed to the non-COVID cohort (71.7%), with a p-value of 0.015. Although the COVID cohort experienced a higher rate of in-hospital mortality at 11.3% compared to 6.9% in the non-COVID cohort (p < 0.001), there were no significant differences in the rates of death within 30 days of admission (COVID cohort: 25.6% vs. non-COVID cohort: 27.6%, p = 0.349) or within 90 days of admission (COVID cohort: 28.9% vs. non-COVID cohort: 31.7%, p = 0.195) between the two cohorts. Conclusions: Oncology patients with COVID-19 faced longer hospital stays and higher in-hospital mortality rates than those without COVID-19. However, the COVID-19 cohort had a lower rate of readmission within 30 days after discharge. Despite the greater severity of hospitalization for COVID-19 patients, the mortality rates 30 and 90 days post-admission did not significantly differ from those without COVID-19. These findings underscore the need for intensified care and monitoring of hospitalized oncology patients with COVID-19, while also acknowledging the comparable longer-term survival between the cohorts.