Abstract 1748P
Background
Globally, United Kingdom (UK) has the second highest mortality rate from COVID-19. Risk factors include cancer and lung disease; thus thoracic cancer pts are especially vulnerable.
Methods
Thoracic cancer pts diagnosed with COVID-19 (PCR, radiological or clinical) at a UK academic centre between March-May 2020 were included. Data were extracted from pts records. Demographics, treatment and outcomes are described.
Results
27 pts were included, 12 (44%) diagnosed by PCR, 4 (15%) radiologically and 11 (41%) clinically. 89% had advanced thoracic malignancies. Symptoms included dyspnoea (52%), cough (67%), fever (59%), fatigue (37%), confusion (22%), diarrhoea (11%), anosmia (7%). 14 (52%) patients were hospitalised (median 6d); 4 (15%) required intensive care (ICU), of which 3 died. 10 (37%) pts required oxygen, 4 (14%) required non invasive ventilation. No pts were intubated. Complications included pneumonia (26%), sepsis (11%) and ARDS (7%). 2 pts required home oxygen at discharge. 5 (19%) pts died; all were smokers. Median time from symptom onset to death was 10d (range 3-13). Cancer therapy was delayed or ceased in 11 (41%) patients. Table: 1748P
Demographics
| Total n (%) N=27 | Died n (%) N=5 | |
| Age | ||
| Median (years) | 71 | 73 |
| Sex | ||
| Male | 16 (59) | 4 (80) |
| Female | 11 (41) | 1 (20) |
| Ethnicity | ||
| White | 23 (85) | 4 (80) |
| Other | 4 (15) | 1 (20) |
| Smoking | ||
| Never | 6 (22) | 0 |
| Ex/current | 21 (78) | 5 (100) |
| ECOG | ||
| 0-2 | 27 (100) | 5 (100) |
| Comorbidities | ||
| COPD | 9 (33) | 2 (40) |
| Cardiac | 4 (15) | 2 (40) |
| Diabetes | 3 (11) | 0 |
| Medication | ||
| Steroids | 4 (15) | 1 (20) |
| Cancer type | ||
| NSCLC | 22 (81) | 3 (60) |
| SCLC | 1 (4) | 0 |
| Mesothelioma | 2 (7) | 1 (20) |
| Thymoma/Thymic | 2 (7) | 1 (20) |
| Current stage | ||
| 1-2 | 3 (11) | 1 (20) |
| 3-4 | 24 (89) | 4 (80) |
| Current treatment | ||
| None | 8 (30) | 2 (40) |
| Immunotherapy | 2 (7) | 0 |
| Chemotherapy | 4 (15) | 2 (40) |
| Chemoimmunotherapy | 7 (26) | 1 (20) |
| TKI | 5 (18) | 0 |
| Radiation | 1 (4) | 0 |
Conclusions
Despite UK patient shielding and risk-minimizing therapy modifications, the immediate morbidity from COVID-19 remains high in thoracic cancer pts. Rates of hospitalisation and treatment interruption were high. Although numbers were small, no deaths occurred in never smokers or pts on single modality therapy. Continued follow up is needed to better understand the direct and indirect impacts of COVID-19 on morbidity and subsequent mortality.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
A.R. Minchom: Honoraria (self): Loxo Oncology; Honoraria (self): Janssen Pharmaceuticals; Honoraria (self): Faron Pharmaceuticals; Honoraria (self): Bayer Pharmaceuticals; Honoraria (self): Novartis Oncology; Honoraria (self): Merck Pharmaceuticals. M. Ahmed: Advisory/Consultancy, Research grant/Funding (self): BMS; Research grant/Funding (self): MSD; Speaker Bureau/Expert testimony: AstraZeneca. F. McDonald: Speaker Bureau/Expert testimony: Elekta; Advisory/Consultancy, Speaker Bureau/Expert testimony: Astra Zeneca; Advisory/Consultancy: Accuray; Research grant/Funding (institution): MSD. S. Popat: Advisory/Consultancy: BMS; Advisory/Consultancy: Roche; Advisory/Consultancy: Takeda; Advisory/Consultancy: Astra Zeneca; Advisory/Consultancy: Pfizer; Advisory/Consultancy: MSD; Advisory/Consultancy: EMD Serono; Advisory/Consultancy: Guardant Health; Advisory/Consultancy: Abbvie; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy: OncLive; Advisory/Consultancy: Medscape; Advisory/Consultancy: Incyte; Advisory/Consultancy: Paradox Pharmaceuticals; Advisory/Consultancy: Eli Lilly. All other authors have declared no conflicts of interest.