Outcomes of patients with cancer infected with SARS-CoV-2: results from the Ion Chiricuţă Oncology Institute series.

BACKGROUND

The evolution of COVID-19 is a controversial topic in cancer patients. They have been designated by international organizations as a vulnerable population at greater risk for contracting SARS-CoV-2 and having a more severe clinical outcome.

PATIENTS AND METHODS

Active screening at our institution became routine early in the pandemic. We have examined the clinical data of 341 cancer patients, with a positive RT-PCR SARS-CoV-2 test between April 2020 and February 2021, in the prevaccination era.

RESULTS

During the infection, 40.5% remained asymptomatic, 27.6% developed a mild form, 20.5% had a moderate form, and 11.4% a severe/critical form of COVID-19 that led to death in 7.6% of cases. Treatment was adapted to disease severity according to national guidelines. In our series, the incidence of COVID-19 infection was lower in cancer patients compared with the general population (P < 0.001), however, the mortality rate was higher in cancer patients in comparison with the general population (7.6% versus 2.9%, P < 0.001). The prognostic factors were assessed by three distinct univariate and multivariate analyses: (i) evolution to a moderate or severe/critical clinical manifestation, (ii) clinical worsening (severe/critical form or death), and (iii) overall survival. In the multivariate analysis, the prognostic factors associated with the evolution to a moderate or severe/critical clinical manifestation were: performance status (PS) (P < 0.0001) and no active treatment in the previous 3 months (P = 0.031). Factors associated with clinical worsening were: PS (P < 0.0001), peripheral arterial disease (P = 0.03), and chronic liver disease (P = 0.04). Factors associated with impaired overall survival were PS (P < 0.0001), ischemic cardiac disease (P = 0.0126), chronic liver disease (P = 0.001), and radiotherapy (P = 0.0027).

CONCLUSION

Our series confirms a more severe evolution for COVID-19 infection in cancer patients, with PS as the most prominent prognostic factor in all three multivariate analyses. By active screening, efforts should be in place to keep cancer units as coronavirus-free sanctuaries.

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure ACP reports personal fees from Roche, Merck Serono, Sandoz, support for attending meetings and/or travel from Accord, Pfizer, grants from University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, outside the submitted work. TC reports personal fees from Astellas Pharma, Janssen, Merck Sharp & Dohme, Merck Serono, Amgen, Roche, Pfizer, Sanofi Genzyme, Servier, Ipsen, AstraZeneca, Lilly, Novartis, Boehringer Ingelheim, Bristol Myers Squibb, grants from University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, outside the submitted work. PK reports personal fees from Roche, Sandoz, Bristol Myers Squibb, AstraZeneca, Merck Serono, Pproevents, Astellas Pharma, support for attending meetings and/or travel from Sandoz, Elli Lilly, Roche, Boehringer Ingelheim, grants from University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Romanian National Authority for Scientific Research, COST Association, outside the submitted work. CM reports support for attending meetings and/or travel from Roche, Pfizer, Accord, outside the submitted work. MBV reports support for attending meetings and/or travel from Roche, Pfizer, Accord, Servier, outside the submitted work. CV reports grants from the Romanian National Authority for Scientific Research, COST Association, outside the submitted work. All other authors have declared no conflicts of interest.