Abstract 1685P
Background
There are no large reported series determining the outcome of cancer patients with COVID-19. We aimed to determine whether differences exist in COVID-19 related mortality between cancer patients and the general population in our hospital, and we also describe associated risk factors.
Methods
We reviewed 2216 medical records of all patients admitted to hospital with COVID-19 diagnosis between 5 March and 13 May 2020. Study data were collected using REDCap electronic data capture tools. We described COVID-19 cumulative incidence in cancer patients, treatment outcome, mortality and associated risk factors.
Results
We detected 85/2216 cancer patients in all COVID-19 diagnoses. Mortality rate: 40/85 cancer patients vs 260/2131 patients in the general ward (P<0.001). Median age: 76 years old (34-94), 50/85 male patients. Most frequent histologies: lung cancer (22/85), colorectal cancer (19/85) and prostate cancer (15/85). Most frequent staging: metastatic disease (32/85). Only 2/85 patients were admitted to ICU. Mortality was associated with older median age (79.5 vs 73, P=0.03), high d dimer levels (1630 vs 830, P=0.03), high LDH levels (315.5 vs 224, P=0.003), bilateral pneumonia (24/42 vs 5/22 with unilateral pneumonia, P=0.02), acute respiratory distress syndrome (ARDS) (12/13 vs 28/72 without ARDS, P<0.0001) and metastatic disease (20/32 metastatic vs 20/53 non-metastatic, P=0.02). Differences were maintained in multivariate analyses regarding ARDS (OR 23.7, P=0.007) and metastatic disease (OR 2.5, P=0.05).
Combined treatment with hydroxychloroquine and azithromycin showed a better outcome in uni and multivariate analyses with only 21/61 dead patients (OR 0.13, P=0.005), adjusted by sex, histology, staging, ARDS and comorbidities.
Conclusions
COVID-19 had significant mortality in cancer patients. High D dimer and LDH levels and ARDS development in elderly metastatic patients carry an elevated risk of death in cancer patients diagnosed with COVID-19. However, only 2/85 patients were admitted to ICU and this data was decisive. Combined hydroxychloroquine and azithromycin could be a good treatment option in COVID-19 cancer patients. It is a priority to create measures to avoid COVID-19 transmission in oncological patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Medical Oncology Department, HU Infanta Leonor.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.