COVID-19 and Cancer: A Comparative Case Series

Abstract

BackgroundCancer patients, with an incidence of more than 18 million new cases per year, may constitute a significant portion of the COVID-19 infected population. In the pandemic situation, these patients are considered highly vulnerable to infectious complications due to their immunocompromised state.Material & MethodsIn this retrospective case series, the documents of solid cancer patients infected by SARS-CoV-2, hospitalized in Shariati hospital (a tertiary care referral center designated for COVID-19 patients, affiliated by Tehran University of Medical Sciences) between 20 February and 20 April 2020, were evaluated. The diagnosis of COVID-19 was based on a positive real-time fluorescence reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 nucleic acids from nasal and/or pharyngeal specimens and/or features of chest CT scan highly suggestive for SARS-CoV-2.ResultsAmong 33 patients with solid cancer, 11 patients had a positive RT-PCR for SARS-CoV-2 and 22 patients had highly suggestive chest CT scan findings in favor of SARS-CoV-2 but negative RT-PCR . The mean age of the patients was 63.9 years, and 54.5% of the patients were males. Age and sex of the patients did not correlate with mortality. There was no difference in COVID-19 symptoms, lymphocytopenia, thrombocytopenia between survived and un-survived cancer patients. However, LDH level was significantly higher (7170±2077 vs. 932.3±324.7, P-value=0.016) and also serum albumin was significantly lower in un-survived group (3.6±0.5 vs. 2.9±0.6 p-value=0.03). Among 16 patients with stage IV cancer, thirteen patients died, which was significantly higher compared to stage I-III cancer patients (81.3% vs. 18.8% P-value= <0.001). In terms of developing complications, sepsis, invasive ventilation and mortality was significantly higher in patients who received cytotoxic chemotherapy within the last 14 days. There was no significant difference between the two groups of positive and negative SARS-CoV-2 RT-PCR regarding their sex, age, cancer type, mean Hemoglobin concentration, Platelet count, lymphocyte count, serum albumin level, ESR and CRP titer or other laboratory findings and also in terms of clinical symptoms and coexisting.ConclusionIn this study, we showed that the mortality rate among cancer patients affected by COVID-19 was higher than general population and this rate has a significant correlation with factors such as the stage of the disease, the type of cancer, the activity of cancer and finally receiving cytotoxic chemotherapy within 14 days before diagnosis of COVID-19. We also showed that the outcome of cancer patients with positive RT-PCR for COVID-19 similar to those with negative RT-PCR with highly suggestive chest CT scan findings.

A Case of Severe COVID-19 Infection in a Patient with Acute Myeloid Leukaemia: Critical Care Management and a Review of the Literature

“…The current pandemic has further increased the susceptibility of such patients to infections. 3 One such risk group of patients who have a high mortality rate with COVID-19 infection are patients with haematological malignancies. 4 However, patients with benign disorders like sickle cell disease are also prone.…”