LBA80 - Outcome and prognostic factors of SARS CoV-2 infection in cancer patients: A cross-sectional study (SAKK 80/20 CaSA)

Background

There is ongoing controversy regarding the outcome of COVID-19 in cancer patients. This is one of few registries on the impact of COVID-19 in cancer patients in a country severly affected by the pandemic.

Methods

This cohort study is collecting data on symptomatic Sars-CoV-2 infected patients with a cancer diagnosis from 23 Swiss sites, starting March 1, 2020. The main objective of the study is to assess the outcome of COVID-19 infection in patients with solid and hematological malignancies, while the main secondary objective is to define prognostic factors of COVID-19 outcome.

Results

With a cutoff date of July 16, 2020, 357 patients with a diagnosis of cancer and symptomatic COVID-19 were included into this first analysis. The most frequent malignancies were breast in 63 cases (18%), lung in 40 cases (11%), prostate cancer in 24 cases (7%) and myeloma in 16 cases (5%), with 104 (38%) patients having non-curative disease. Anticancer treatment within 3 months prior to the diagnosis of COVID-19 included chemotherapy in 65 patients (18%), targeted therapy in 54 patients (15%), steroids in 39 (11%), checkpoint inhibitors in 22 (6%) or no anticancer treatment in 155 patients (43%). 230 patients (65%) were hospitalized for COVID-19 or were already in hospital; 167 of the hospitalized patients (73%) required oxygen treatment, 43 patients (19%) intensive care, 31 (14%) invasive ventilation. 63 patients died from COVID-19 infection, resulting in a mortality rate of 18%. Significant risk factors for death included age ≥65 versus <65 (HR 5.84, p<0.001) and non-curative versus curative disease (HR 2.34, p=.01). Neither male versus female gender (HR 1.59, p=0.12), type of cancer, geographic region, chemotherapy (HR 1.31, p=0.44), cardiovascular disease (HR 2.25, p=0.09) nor pulmonary comorbidity (HR 0.93, p=0.86) were significant risk factors for death.

Conclusions

We found a COVID-19 mortality rate in real-world cancer patients in a country with a decentralized, high-quality health care system that is substantially higher than in all COVID-19 infected patients in Switzerland (18% versus 5%). The rate of hospitalization and intensive care from COVID-19 in cancer patients is substantial.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Swiss Clinical Cancer Research Group.

Funding

Swiss Clinical Cancer Research Group.

Disclosure

All authors have declared no conflicts of interest.