Abstract 1679P
Background
The severity of SARS-CoV-2 infection (COVID-19) is predicted by advancing age and co-morbidities. The relative contribution of cancer in influencing the course of COVID-19 is poorly understood. We designed the OnCOVID study to investigate natural history of COVID-19 disease in cancer patients.
Methods
This retrospective, multi-center observational study conducted across 8 tertiary centers in Europe recruited cancer patients aged >/= 18 and diagnosed with COVID-19 between February 26th and April 1st, 2020. Descriptive statistics, univariable and multivariable Cox regression models were used to assess patient’s main characteristics and to evaluate the factors associated to COVID-19 related mortality.
Results
We identified 204 patients from United Kingdom (n=97, 48%), Italy (n=56, 27%) and Spain (n=51, 25%). Most patients were male (n=127, 62%) had a diagnosis of solid malignancy (n=184, 91%) and 103 (51%) had non-metastatic disease. Mean (±SD) patient age was 69±13 years, and 161 (79%) had >/= 1 co-morbidity, most commonly hypertension (n=88, 43%) and diabetes (n=46, 23%). Commonest presenting symptoms were fever (n=136, 67%) and cough (n=119, 58%), beginning 3.8 (±4.5 SD) days before diagnosis. Most patients (n=141, 69%) had >/= 1 complication from COVID-19, including respiratory failure (n=128, 63%) and acute respiratory distress syndrome (n=49, 24%). In total, 36 patients (19%) patients were escalated to high-dependency or intensive care. At time of analysis, 59 patients had died (29%), 53 were discharged from hospital (26%) and 92 (45%) were in-hospital survivors. Mortality was higher in patients aged >/= 65 (36% versus 16%), in those with >/= 2 co-morbidities (40% versus 18%) and developing >/= 1 complication from COVID-19 (38% versus 4%, p=0.004). Multi-variable analyses confirmed age >/= 65 and >/= 2 co-morbidities to predict for patient mortality independent of tumor stage, active malignancy or anti-cancer therapy.
Conclusions
In the early outbreak of SARS-CoV-2 infection in Europe co-morbid burden and advancing age predicted for adverse disease course in cancer patients. Risk stratification based on these factors should inform personalized oncological decision making during the COVID-19 pandemic.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Imperial College London.
Funding
Has not received any funding.
Disclosure
D.J. Pinato: Speaker Bureau/Expert testimony, received lecture fees : ViiV Healthcare; Speaker Bureau/Expert testimony, received lecture fees : Bayer Healthcare; Travel/Accommodation/Expenses: BMS; Advisory/Consultancy: Mina Therapeutics; EISAI; Roche; Astra Zeneca; Research grant/Funding (institution): MSD; BMS. A. Patriarca: Advisory/Consultancy: Takeda; Sanofi. G. Gaidano: Advisory/Consultancy, Speaker Bureau/Expert testimony: Janssen; Abbvie; Advisory/Consultancy: AstraZeneca; Sunesys. J. Brunet: Advisory/Consultancy: MSD; AstraZeneca. J. Tabernero: Advisory/Consultancy: Array Biopharma; Astra Zeneca; Bayer; Beigene; Boehringer Ingelheim; Chugai; Genentech; GenMab; Halozyme; Inflection Biosciences Limited; Ipsen; Kura; Lilly; MSD; Menarini; Merck Serono; Merrimack; Merus; Molecular Partners; Novartis; Peptomics; Pfizer; Pharmacyclics; Rafael Pharmaceuticals; ProteoDesign SL; F. Hoffmann-La Roche Ltd; Sanofi; Servier; Seagen; Symphogen, Taiho, VCN Biosciences, Biocartis, Foundation Medicine, HalioDX SAS and Roche Diagnostics. A. Prat:Honoraria (self), Advisory/Consultancy: Pfeizer; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self): Novartis; Roche; Honoraria (self): MSD Oncology; Lilly; Honoraria (self), Travel/Accommodation/Expenses: Daiichi Sankyo; Advisory/Consultancy: BMS; Amgen; NanoString Technologies. A. Gennari: Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Roche; Eli Lilly; EISAI; Advisory/Consultancy: Pierre Fabre; MSD; Novartis; Advisory/Consultancy, Speaker Bureau/Expert testimony: Daiichi Sankyo; Speaker Bureau/Expert testimony: Teva; Gentili; Pfizer; AstraZeneca; Celgene. All other authors have declared no conflicts of interest.