COVID-19 fatality rate highest among cancer patients in Mumbai

Cancer patients have the highest COVID-19 fatality rate as compared to the overall fatality rate of Mumbai. According to the data shared by the Tata Memorial Hospital in Parel, cancer patients with novel coronavirus have a case fatality rate (CFR) of 9.8 percent which is three times higher than the city’s CFR which is 3.9 percent. However, due to lesser consumption of cigarettes, the fatality rate is less than that of the western countries.

The hospital is running three COVID-19 centres where 1,140 cancer patients have undergone treatment for co-infection. Out of these, 112 of them have succumbed to the infection. Patients above the age group of 50 years have recorded the highest death rate. However, oncologists believe that in comparison to western counties, the death rate of co-infected cancer patients is less in India. They claim that as the consumption of chewing tobacco is more in India, their lungs are healthier which has saved them from the COVID-19 infection. As a report published by the Lancet in August 2020, patients with blood cancer are most vulnerable to the infection.

As per the statistics, 2,57,497 individuals have contracted COVID-19 in Mumbai, of which 10,293 succumbed to the infection. On the other hand, the TMH—the leading cancer hospital in India which receives 70,000 cancer patients every year, has treated 1,140 cancer patients with COVID-19 co-infection between March and October. Out of this, 112 of the patients succumbed to the pandemic during their treatment.

Senior oncologists said the cancer patients are more prone to contract a virus or any infections due to the weak immune system following which the death rate is much higher amongst them.

“Among immunocompromised patients, the body's white blood cells, which fight infections, become low or don't function. This fails the body to fight with the infections effectively. This makes cancer patients especially those who are on active chemotherapy most vulnerable to the infection,” said Dr C S Pramesh, director, TMH. Moreover, the infection and mortality rate is the highest among cancer patients above the age of 50 years. “If they have other comorbidities, their infection becomes more deadly,” he added.

Akash Aanand, assistant medical superintendent of Homi Bhabha Cancer Hospital, a unit of TMH, Varanasi said cancer patients who are actively on treatment are at more risk than those who are in remission.

“Active cancer patients had to be extra cautious due to their low immunity. Since March, we have treated 141 COVID-19 positive patients with cancer. Out of this, only 5 have succumbed to the virus,” he said.

In a study—‘COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort’ study published by the Lancet shows that the mortality rate is 30.6 percent. The researchers conducted the study on 1,044 cancer patients with co-infection at the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 2020, of which 316 patients died.

According to city-based oncologists, patients with haematological malignancies are at risk when cancer affects the blood, bone marrow, and lymph nodes.

“Patients with haematological malignancies are the most at risk. Their cancers directly affect their immune system. Thus, they fail to fight with the virus. Also, it has been observed that during therapies it can cause severe myelosuppression (bone marrow suppression which reduces the production of blood cells) and lymphodepletion (destruction of lymphocytes and T cells),” said Dr S Chandrakala, haematologist, King Edward Memorial, Parel.

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