Background: The outbreak of the COVID-19 pandemic has led to unprecedented disruptions to global cancer care delivery. We conducted this multidisciplinary survey to gain insights into the real-life impact of the pandemic as perceived by cancer patients.Methods: Cancer patients at various stages of their cancer journeys were surveyed with a questionnaire constructed by a multidisciplinary panel of oncologists, clinical psychologists, occupational therapists, physiotherapists and dieticians. The 64-question survey covered patient's concerns on cancer care resources, treatment provision and quality, changes in health-seeking behaviour; the impact of social isolation on physical wellbeing and psychological repercussions.

Background: There is uncertainty as to the contribution of cancer patients' features on severity and mortality from Covid-19 and little guidance as to the role of anticancer and anti-Covid-19 therapy in this population.Methods: OnCovid is a retrospective observational study conducted across 19 European centers that recruited cancer patients aged >18 and diagnosed with Covid-19 between 26/02 and 01/04/2020. Uni-and multivariable regression models were used to evaluate predictors of Covid-19 severity and mortality.Results: We identified 890 patients from UK (n¼218, 24%), Italy (n¼343, 37%), Spain (n¼323, 36%) and Germany (n¼6, 1%). Most patients were male (n¼503, 56%) had a diagnosis of solid malignancy (n¼753, 84%) and 556 (62%) had active disease. Mean (AESD) patient age was 68AE13 years, and 670 (75%) had >1 co-morbidity, most commonly hypertension (n¼386, 43%). Commonest presenting symptoms were fever (n¼569, 63%) and cough (n¼448, 50%), beginning 6.3 (AE9.5 SD) days before diagnosis. Most patients (n¼565, 63%) had >1 complication from Covid-19, including respiratory failure (n¼527, 59%) and acute respiratory distress syndrome (n¼127, 22%). In total, 110 patients (14%) were escalated to high-dependency or intensive care. At time of analysis, 299 patients had died (33%). Multi-variate logistic regression identified male gender, age>65 (p<0.0001) presence of >2 comorbidities (p¼0.001) active malignancy (p¼0.07) as predictors of complicated Covid-19. Mortality was associated with active malignancy (p<0.0001), age>65 and co-morbid burden (p¼0.002). Provision of chemotherapy, targeted therapy or immunotherapy was not associated with higher mortality. Exposure to anti-malarials alone (chloroquine/ hydroxychloroquine, n¼182, p<0.001) or in combination with anti-virals (n¼195, p<0.001) or tocilizumab (n¼51, p¼0.004) was associated with improved mortality compared to patients who did not receive any of these therapies (n¼446) independent of patients' gender, age, tumour stage and severity of Covid-19.Conclusions: This study highlights the clinical utility of demographic factors for individualized risk-stratification of patients and supports further research into emerging anti Covid-19 therapeutics in SARS-Cov-2 infected cancer patients. Clinical trial identification: NCT04393974.Legal entity responsible for the study: Imperial College London.