Tian (2020)
Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study
Laboratory Findings
D-dimer (1 unit increase vs. Not applicable)
COVID-19 (severe/critical)
Odds ratio: 1.120 (1.030-1.210) Adjusted model


Retrospective cohort study

Medical records


We included all adult patients (13077 patients with confirmed SARS-CoV-2 infection ; aged>=18 years) with any type of malignant solid tumours and haematological malignancy who were admitted to nine hospitals in Wuhan, China, with laboratory-confirmed COVID-19 between Jan 13 and March 18, 2020.

Among these patients, 232 patients with cancer and 519 matched patients without cancer were enrolled in this study. Patients were followed up until March 26, 2020. 166 (32%) of 519 patients without cancer and 148 (64%) of 232 patients with cancer had severe COVID-19 at hospital admission. 614 patients were included in the early stage group (ie, hospital admission between Jan 13 and Feb 16, 2020) and 137 in the late stage group (hospital admission between Feb 17 and March 18, 2020). Eight (10%) patients with cancer who were admitted with non-severe COVID-19 and 38 (26%) patients with cancer who were admitted with severe COVID-19 died during follow-up.


29 Day

COVID-19 (severe/critical)


Patients had severe disease if they had any of the following criteria: respiratory rate of at least 30 breaths per min, oxygen saturation of 93% or lower in a resting state, ratio of arterial partial pressure of oxygen and oxygen concentration no greater than 300 mm Hg, or more than 50% lesion progression in lung imaging within 24–48 h

Laboratory Findings


coagulation-related indicators - D-dimer, ug/mL

Not applicable

1 unit increase

Odds ratio

1.120 (1.030-1.210)




Risk was adjusted for 1) Age 2) Eastern Cooperative Oncology Group (ECOG) 3) Tumour stage of IV 4) Antitumour treatments including Chemotherapy or radiotherapy and Targeted therapy or immunotherapy 5) Cytokines including Tumor necrosis factor alpha (TNF alpha), Interleukin 6 (IL-6), and IL-2 receptor (IL-2R) 6) Infection-related biomarkers like Procalcitonin and C-reactive protein 7) Immune cells including lymphocytes, CD3-CD19+ B-cell count, CD4+ T cells, and natural killer cells 8) Haematological tests like Leucocyte count, Neutrophils and Monocytes 9) Biochemical factors including Lactate dehydrogenase, Albumin, Albumin–globulin ratio, N-terminal pro-B-type natriuretic peptide (NT-proBNP), Myoglobin and high-sensitivity cardiac troponin I (hs-cTnI) 10) Coagulation-related indicators like Platelet count, Activated partial thromboplastin time, Prothrombin time, D-dimer.

Note : Time of follow-up was defined as the duration from hospital admission to outcomes (survivor or nonsurvivor) of patients; survivors were defined as patients who were discharged from hospital or still hospitalised at the end of the study.