LBA83 - Outcomes of the 2019 novel coronavirus in patients with or without a history of cancer: A multi-centre North London experience

Background

The high prevalence and associated healthcare, social and economic challenges of the 2019 novel coronavirus disease (COVID-19) suggests this pandemic is likely to have a major impact on cancer management, and has been shown to potentially have worse outcomes in this cohort of vulnerable patients. This study aims to compare the outcomes of RT-PCR confirmed COVID-19 positive disease in patients with or without a history of cancer.

Methods

We retrospectively collected clinical, pathological and radiological characteristics and outcomes of COVID-19 RT-PCR positive cancer patients treated consecutively in 5 different North London hospitals (cohort A) and compared their outcomes to consecutively admitted COVID-19 positive patients without a history of cancer (cohort B). Patients were matched for age, gender and comorbidty and treated during the same time period (1st March- 30th April 2020).

Results

The median age in both cohorts was 74 years, with 67% male, and comprised of 30 patients with cancer, and 90 without (1:3 ratio). For cohort B, 579 patients without a history of cancer and consecutively admitted were screened from the primary London hospital, 105 were COVID-19 positive and 90 were matched and included. Excluding cancer, both cohorts had a median of 2 comorbidities. The odds ratio (OR) for mortality, comparing patients with cancer to those without, was 1.05 (95% CI 0.4-2.5), and severe outcome (OR 0.89, 95% CI 0.4-2.0) suggesting no increased risk of death or a severe outcome in patients with cancer. Cancer patients who received systemic treatment within 28 days had an OR for mortality of 4.05 (95% CI 0.68-23.95), p=0.12. On presentation anaemia, hypokalaemia, hypoalbuminaemia and hypoproteinaemia were identified predominantly in cohort A. Median duration of admission was 8 days for cancer patients and 7 days for non-cancer.

Conclusions

Old age, late stage of cancer diagnosis and multiple co-morbidities adversely influence the outcome of patients with COVID-19 positive patients. These data do not demonstrate a higher risk to cancer patients compared to their non-cancer counterparts. If a second peak of pandemic strikes, a coordinated response of all overlapping specialities in the fight against cancer is required.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Research and Ethics Committee North Middlesex University Hospital.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.