Wuhan Cancer Patient COVID-19 Cases Described

Author: By Lynda Williams, Senior medwireNews Reporter 

medwireNews: Chinese clinicians have reported data on the incidence of the severe adult respiratory syndrome coronavirus 2 (SARS-CoV-2) among cancer patients in Wuhan in a research letter to JAMA Oncology. 

Conghua Xie, from Zhongnan Hospital of Wuhan University, and co-authors estimate that 0.79% of 1524 patients admitted to Zhongnan Hospital between 30th December 2019 and 17th February 2020 became infected with SARS-CoV-2 and developed COVID-19. 

This compares with a cumulative incidence of COVID-19 of 0.37% among 11,081,000 individuals in the city of Wuhan by data cutoff on 17th February 2020, the researchers say. 

The 12 patients with COVID-19 were aged between 48 and 78 years and eight patients were aged over 60 years; the majority (58.3%) had non-small-cell lung cancer (NSCLC). 

At the time of infection, one patient with a new diagnosis of colon cancer was awaiting treatment, and two NSCLC patients had completed neoadjuvant chemotherapy and surgery, or chemoradiotherapy. 

One breast cancer patient was undergoing adjuvant radiotherapy, and four NSCLC patients were at the following stages of treatment: undergoing concurrent osimertinib and thoracic radiation; week 5 of chemotherapy plus radiation; completed the first cycle of docetaxel, cisplatin plus sintilimab; and completed the third cycle of pemetrexed, carboplatin and pembrolizumab therapy. 

The remaining four patients were undergoing best supportive care for NSCLC, rectal cancer, pancreatic cancer or urothelial cancer. 

Three patients developed severe COVID-19, one of whom required intensive care. At time of publication half of the 12 patients had been discharged and three patients had died. 

“This study highlights the following observations: patients with cancer from the epicenter of a viral epidemic harbored a higher risk of SARS-CoV-2 infection ([odds ratio]=2.31) compared with the community”, but that “fewer than half of these infected patients were undergoing active treatment for their cancers”, summarise Conghua Xie et al. 

The authors further investigated the incidence of SARS-CoV-2 infection among the 228 NSCLC patients in the overall cohort. Just over half (51.3%) of these patients were aged over 60 years and these patients were more likely to develop COVID-19 pneumonia than their younger counterparts, at a rate of 4.3% versus 1.8%. 

“[W]e observed that older patients (>60 years) and patients with NSCLC may be at risk of COVID-19”, the authors write, but acknowledge that an earlier population study of 1099 patients “did not indicate that age was associated with susceptibility to infection.” 

“A larger sample size in patients with cancer will resolve these potential associations”, they say. 

Reference  

Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China. JAMA Oncol; Advance online publication 25 March 2020. doi:10.1001/jamaoncol.2020.0980