SARS-CoV-2 infection in cancer patients undergoing active treatment: analysis of clinical features and predictive factors for severe respiratory failure and death.
Aged
Antineoplastic Agents
/ adverse effects
Betacoronavirus
/ isolation & purification
COVID-19
Coronavirus Infections
/ complications
Female
Humans
Immunotherapy
/ adverse effects
Male
Middle Aged
Mortality
Neoplasms
/ complications
Pandemics
Pneumonia, Viral
/ complications
Prognosis
Prospective Studies
Respiratory Insufficiency
/ diagnosis
Retrospective Studies
Risk Assessment
SARS-CoV-2
2019 novel coronavirus infection
Adult
COVID-19 virus disease
Cáncer
Mortality
Predictive factors
Respiratory distress syndrome
Treatment
Journal
European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
23
05
2020
accepted:
01
06
2020
pubmed:
27
6
2020
medline:
29
7
2020
entrez:
27
6
2020
Statut:
ppublish
Résumé
Previous studies have suggested a more frequent and severe course of novel coronavirus SARS-CoV-2 infection in cancer patients undergoing active oncologic treatment. Our aim was to describe the characteristics of the disease in this population and to determine predictive factors for poor outcome in terms of severe respiratory distress (acute respiratory distress syndrome [ARDS]) or death. Patients consecutively admitted for SARS-CoV-2 infection were prospectively collected, and retrospective statistical analysis was performed. Univariate and multivariate analyses were performed to assess potential factors for poor outcomes defined as ARDS or death. Sixty-three patients were analysed, and 34 of them developed respiratory failure (70% as ARDS). Lymphocytes/mm3 (412 versus 686; p = 0.001), serum albumin (2.84 versus 3.1); lactate dehydrogenase (LDH) (670 versus 359; p < 0.001) and C-reactive protein (CRP) levels (25.8 versus 9.9; p < 0.001) discriminate those that developed respiratory failure. Mortality rate was 25%, significantly higher among ARDS, neutropenic patients (p = 0.01) and in those with bilateral infiltrates (44% versus 0%; p < 0.001). Multivariate logistic analyses model confirmed the predictive value of severe neutropenia (odds ratio [OR] 16.54; 95% confidence interval [CI] 1.43-190.9, p 0.025), bilateral infiltrates (OR 32.83, CI 95% 3.51-307, p 0.002) and tumour lung involvement (OR 4.34, CI 95% 1.2-14.95, p 0.02). Cancer patients under active treatment admitted for SARS-CoV-2 infection have worse outcomes in terms of mortality and respiratory failure rates compared with COVID-19 global population. Lymphopenia, LDH, CRP and albumin discriminate illness severity, whereas neutropenia, bilateral infiltrates and tumour pulmonary involvement are predictive of higher mortality.
Identifiants
pubmed: 32586724
pii: S0959-8049(20)30313-0
doi: 10.1016/j.ejca.2020.06.001
pmc: PMC7275164
pii:
doi:
Substances chimiques
Antineoplastic Agents
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
242-250Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest statement None declared.
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