Coronavirus Disease-2019 in Cancer Patients. A Report of the First 25 Cancer Patients in a Western Country (Italy)

Abstract

<jats:p> Background: We describe cancer patients with coronavirus disease-2019 (COVID-19) infection treated at the Piacenza’s general hospital (north Italy). Materials &amp; methods: 25 cancer patients infected by COVID-19 admitted at the Piacenza’s general hospital from 21 February to 18 March 2020. Outcome from the infection were compared with infected noncancer patients. Results: 20 patients (80%) were treated with antiviral therapy and hydroxychloroquine and five (20%) received hydroxychloroquine alone. Nine (36%) patients died, while 16 (64%) overcome the infection. In the control group the mortality was 16.13% and the overcome from infection was 83.87%. Conclusion: Mortality for COVID-19 was greater in cancer patients when compared with noncancer patients, worse prognosis for older age, women and patients treated with hydroxychloroquine alone. However, the comparisons did not reach statistical significance in most cases. This could be due to the small sample size that is the main limitation of the study. </jats:p>

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

“…with similar mortality in the only report with higher median age [16]), high percentage of stage III-IV disease, predominance of male sex, smoking habit and signi cant comorbidities. Moreover, two of the deceased were already in critical conditions before being infected by COVID-19.…”

“…Additionally, the number of infections and deaths in the general population of our district could have been possibly gone under-detected as only a small fraction of it underwent RT-PCR assays and a large excess in overall mortality has been observed compared to previous years [29]. Among the 13 subjects with COVID-19 diagnosis con rmed by RT-PCR, mortality was 38.5%, higher than previously reported (range 0-36% in previous studies) [13][14][15][16][17][18][19][20][21][22][23][24]. This could be explained by unfavorable characteristics such as higher median age (range 56-68 years in previous studies [13][14][15][16][17][18][19][20][21][22][23],…”

“…This generated a large body of recommendations, surveys and guidelines [7][8][10][11]. Nevertheless, currently published clinical data are still limited, especially considering subjects on active treatment [12][13][14][15][16][17][18][19].…”

“…Previous series, including from 3 to 69 COVID-19 positive patients, reported an infection rate ranging from 0.79% to 2.7% among cancer patients and a mortality rate of 0-36% in infected subjects [13][14][15][16][17][18][19][20][21][22][23]. Only a fraction of the cases were receiving active treatment, mainly consisting of chemotherapy and immunotherapy or target therapy, and infection determined in almost all the cases treatment suspension [13][14][15][16][17][18][19][20][21][22][23].…”

Fatality rate and predictors of mortality in a large Italian cohort of hospitalized COVID-19 patients

“…Cancer has already been described as an independent predictor of death. In particular, in a recent case-control study from an Italian group, COVID-19 patients mortality was signi cantly greater than that of a control group (19).Similarly, obesity was already reported as an independent predictor of mortality in COVID-19, possibly because of the detrimental impact of fat-deriving cytokines on the clinical course of the disease (20,21). Its predictive role is even more relevant considering the low prevalence of obesity in elderly, in our region (9.8% in Piedmont vs. 14.0% in Italy) (22).…”