A snapshot of COVID‐19 infection in patients with solid tumors

• Published in: International Journal of Cancer 2021-05, Vol.148 (10), p.2389-2397
• Main Authors: Fuentes‐Antrás, Jesús, Manzano, Aránzazu, Marquina, Gloria, Paz, Mateo, Aguado, Carlos, Granja, Mónica, Benítez, Javier, Ortega, Justo, Priego, Araceli, González, Carlos, Tejerina‐Peces, Julia, Flores, Paloma, Sa, Alfonso López, Toledano, Carmen, Olalla, Jennifer, Luna, Alicia, Bartolomé, Jorge, Pérez‐Segura, Pedro
• Format: Article
• Language: English
• Subjects: Cancer; Cancer Epidemiology; Cardiovascular diseases; Coronaviruses; Cough; COVID-19; Dyspnea; Epidemiology; Fever; Infections; Leukocytes (neutrophilic); Lung cancer; Malignancy; Medical research; Pandemics; Patients; Respiration; Severe acute respiratory syndrome coronavirus 2; Solid tumors; Tumors
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.33420

Coronavirus disease 2019 (COVID‐19) pandemic is affecting a high percentage of the population at an unprecedented rate. Cancer patients comprise a subgroup especially vulnerable to this infection. Herein, we present a prospective analysis of epidemiological, clinical, radiological and laboratory data of consecutive adult cancer patients seen in the Clínico San Carlos University Hospital (Madrid, Spain), and admitted to hospital and tested for COVID‐19 between 21 February 2020 and 8 May 2020 due to clinical suspicion of infection. Data from 73 patients with confirmed COVID‐19 and active solid tumors or diagnosed within the previous 5 years were analyzed. The most frequent malignancy was lung cancer (19%) and 54 patients (74%) were on active cancer treatment. Most common findings on presentation included cough (55%), fever (52%) and dyspnea (45%), and 32 (44%) patients showed oxygen saturation levels below 95%. Radiologically, 54 (73%) patients presented an abnormal pattern, the most frequent being infiltrates (64%). 18 (24.7%) patients died in hospital and 55 (75.3%) were discharged with clinical resolution of the event. Multivariable logistic regression adjusted for age and tumor stage showed higher odds of in‐hospital death associated with a history of cardiovascular disease, hospitalization in the previous 30 days, and several features on admission including dyspnea, higher qSOFA score, higher C‐reactive protein levels and an abnormal neutrophil count. We present prospective, real‐world evidence that can help articulate cancer care protocols for patients infected with SARS‐CoV‐2, with special focus on features on admission that can stratify patients with a higher risk of death from COVID‐19. What's new? This report provides prospective data about cancer patients with COVID‐19 in a situation of maximum pressure on the healthcare system of a large urban area in Western Europe. Despite a milder clinical profile on presentation, in‐hospital mortality of COVID‐19 was higher in cancer patients than in the general population. The mortality risk was associated with a history of cardiovascular disease and several variables on admission, but seemed not to be influenced by tumor type or anti‐tumor therapy. The evidence could help articulate cancer care protocols for patients infected with SARS‐CoV‐2 and identify patients with a higher risk of in‐hospital death.