Swiss COVID-19 Cancer Patient Outcomes Reported

Author: By Lynda Williams, Senior medwireNews Reporter 

medwireNews: Initial results from the SAKK 80/20 CaSA cross-sectional study of COVID-19 outcomes of Swiss cancer patients show a higher rate of death than for the general population, with age and noncurable cancer strong predictors for mortality. 

Reporting the findings at the ESMO Virtual Congress 2020, Markus Joerger, from Cantonal Hospital in St Gallen, Switzerland, explained that data are being collected for solid and haematological cancer patients who are symptomatic for SARS-CoV-2 infection between 1 March 2020 and 1 March 2021 at 23 Swiss sites. 

By 28 August 2020, 359 patients were entered into the study, 94.4% of whom had a positive nasopharyngeal swab, delegates were told. 

The patients were more often male than female (59.3 vs 40.7%), aged over 65 years (59.3%) and three-quarters had solid tumours, most frequently of the breast (17.5%), lung (11.4%) and prostate (6.7%), or myeloma (4.2%). 

Of note, 61.2% of patients were considered to have noncurable malignancy and 51.8% had received systemic therapy within 3 months of the COVID-19 diagnosis, such as chemotherapy (18.9%), targeted therapy (15.9%), steroids (10.3%), endocrine therapy (9.7%) or a checkpoint inhibitor (6.4%). 

Markus Joerger also noted that the majority (78.8%) of patients had comorbidity, such as cardiovascular disease (49.6%), diabetes (12.3%), lung disease (12.0%), obesity (10.6%) or cachexia or malnutrition (7.5%). 

Overall, 64.5% of patients with COVID-19 were admitted to hospital, 47.1% required oxygen, 12.0% intensive care unit (ICU) admission and 8.6% invasive ventilation, with 17.8% dying. Death occurred in 27.1% of hospitalised patients, 36.1% of patients requiring oxygen and 46.5% of those admitted to an ICU. 

Most (93.1%) patients were given specific treatment for COVID-19, including antibiotics (46.5%), chloroquine (24.6%), antivirals (14.4%) and steroids (11.1%). 

Multiple logistic regression analysis for the first 273 patients and 46 deaths indicated that COVID-19 mortality was significantly predicted by ICU admission (odds ratio [OR]=5.60), age over 65 years (OR=4.68) and noncurative malignancy (OR=2.52).  

But COVID-19 mortality was not significantly linked to sex, geographical region of Switzerland, recent receipt of chemotherapy or immunotherapy, diagnosis of a solid versus haematological malignancy, or comorbid cardiovascular or lung disease, the presenter commented. 

“COVID-19 mortality in Swiss cancer patients was higher than in the general population, roughly 18% versus 5%”, Markus Joerger concluded, with a “substantial” rate of both hospitalisation and ICU admission. 

He added: “A decentralised healthcare system like Switzerland does have outcome data that were quite comparable to highly centralised healthcare systems, like the UK or US.” 

Reference 

Joerger M, Metaxas Y, Schmitt A, et al. Outcome and prognostic factors of SARS CoV-2 infection in cancer patients: A cross-sectional study (SAKK 80/20 CaSA). Ann Oncol 2020; 31 (Suppl 4): S1142–S1215. DOI:10.1016/annonc/annonc325.