Abstract 1681P
Background
COVID-19 pandemic has drastically changed the management of patients with cancer; however, limited data exists regarding which pre-conditions affect the course of COVID-19 infection. Here, we sought to assess the clinical features and outcomes of COVID-19 infection in a large cohort of patients with cancer.
Methods
We conducted a multicenter retrospective cohort study of patients with cancer diagnosed with SARS-CoV-2 infection by RT-PCR/Ag detection (n=274) or CT-scan (N=13) between 7/March and 30/April across 12 international centers. Clinical, pathological and biological data were collected. Primary endpoints were 30-day mortality rate and the rate of severe acute respiratory failure (SARF), defined by oxygen requirements >15 L/min. Descriptive statistics were used.
Results
287 patients were enrolled with a median follow-up of 23 days [95%CI 22-26]. Median age was 69 (range 35-98), 52% were male, 49% had hypertension and 23% had cardiovascular disease. As per cancer characteristics, 68% had active disease, 52% advanced stage and 79% had a baseline ECOG PS ≤1. Most frequent cancer-types were: 26% thoracic, 21% gastrointestinal, 19% breast and 15% genitourinary. Most patients (61%) were under systemic therapy, including chemotherapy (51%), endocrine therapy (23%) and immunotherapy (19%). At COVID-19 diagnosis, 44% of patients had moderate/severe symptoms such as fever (70%), cough (54%) and dyspnea (48%). The majority of patients (90%) required in-patient management and the median hospital stay duration was 10 days (range 1-52); 8% of patients required intermediate or intensive care unit admission. Patients received treatment with: hydroxychloroquine (81%), azithromycin (61%), antiviral therapy (38%) and immunomodulatory drugs (14%). Finally, the overall mortality rate was 27% and the rate of SARF was 26%. In patients admitted to intermediate/intensive care units, the mortality and SARF rates were 45% and 73%, respectively. Mortality rate according to ECOG PS before COVID-19 was 20% in PS≤1 and 51% in PS>2 (p<0.0001).
Conclusions
Patients with cancer are a susceptible population with a high likelihood of severe complications and high mortality from COVID-19 infection. Final results and treatment outcomes will be presented at the ESMO Congress.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Aleix Prat.
Funding
Has not received any funding.
Disclosure
E. Auclin: Travel/Accommodation/Expenses: Mundipharma; Speaker Bureau/Expert testimony: Sanofi Genzymes. S. Pilotto: Speaker Bureau/Expert testimony: Astra-Zeneca; Eli-Lilly; BMS; Boehringer Ingelheim; MSD; Roche. L. Mezquita: Speaker Bureau/Expert testimony, Research grant/Funding (self), Travel/Accommodation/Expenses: Bristol-Myers Squibb; Speaker Bureau/Expert testimony: Tecnofarma; Speaker Bureau/Expert testimony, Non-remunerated activity/ies: AstraZeneca; Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Roche; Research grant/Funding (self): Boehringer Ingelheim. A. Prat: Honoraria (institution), Speaker Bureau/Expert testimony: Roche; Daiichi Sankyo; Honoraria (institution), Advisory/Consultancy, Speaker Bureau/Expert testimony: Pfizer; Novartis; Amgen; Speaker Bureau/Expert testimony: BMS; Advisory/Consultancy: Puma; Oncolytics Biotech; MSD; Honoraria (institution), Advisory/Consultancy: Lilly; Honoraria (institution), Speaker Bureau/Expert testimony: Nanostring technologies; Officer/Board of Directors: Breast International Group; Officer/Board of Directors: Solti's Foundation; Leadership role: Actitud Frente al Cancer Foundation; Honoraria (institution): Boehringer; Honoraria (institution): Sysmex Europa GmbH; Honoraria (institution): Medica Scientia inno. Research; Honoraria (institution): Celgene; Honoraria (institution): Astellas Pharma. All other authors have declared no conflicts of interest.