COVID-19 in cancer patients: clinical characteristics and outcome—an analysis of the LEOSS registry

Abstract

Introduction Since the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk. Patients and methods We retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality. Results In total, 435 cancer patients were included in our analysis. Commonest age category was 76–85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). After adjustments for other risk factors, mortality was comparable. Conclusion Comparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions.

Prognostic factors in patients with advanced cancer and COVID-19: a cohort from the Palliative Care Unit of the Brazilian National Cancer Institute

“…Although we did not find any prognostic association related to sex, it is known that severe cases of COVID-19 and mortality have been associated with male patients in different studies [16,18,19]. Two factors can explain our data: First, the high prevalence of female patients in the general scope of the population often referred to the PCU, as reported by studies carried out in the same place [5,13,20], and second, the high proportion of patients with breast tumors, a disease with a predominant female characteristic, being considered the most prevalent in this sample.…”

“…Liu et al [ 15 ], through a meta-analysis, found that in six selected studies, the age > 65 years old was associated with an increased risk of death (relative risk (RR): 1.27; 95% CI: 1.08–1.49). According to Ruthrich et al [ 16 ], advanced age was associated with higher death rates in a cohort of 435 patients with cancer and confirmed SARS-CoV-2 infection, and enrolled between March 16 and August 31, 2020.…”

2021 update of the AGIHO guideline on evidence-based management of COVID-19 in patients with cancer regarding diagnostics, viral shedding, vaccination and therapy

“…18 The primary endpoint was the efficacy of the vaccine in reducing the cases with laboratory-confirmed J o u r n a l P r e -p r o o f Cancer patients have been shown to be at a higher risk of severe COVID-19, possibly because of older age and more frequent comorbidities. 29 In particular, patients with haematological malignancies are at a persistently increased risk whereas solid tumor patients appear to suffer an increased risk mostly in the first year after diagnosis which drops to baseline >5 years after diagnosis. 30 For any malignancy, active disease confers a significantly increased risk of severe COVID-19.…”

COVID-19: Auswirkungen auf das zentrale und periphere Nervensystem

“…Perspektivisch ist es sinnvoll, weitere mit Bezug auf COVID-19-Erkrankungen und damit verbundene pathologische Merkmale entwickelte klinische Register in die Datenintegration mit einzubeziehen. Das von der DGI (Deutsche Gesellschaft für Infektiologie) und dem DZIF (Deutsches Zentrum für Infektionsforschung) konzipierte „lean european open survey for SARS-CoV‑2 infected patients“ (LEOSS) sammelt europaweit Daten zu Epidemiologie und Krankheitsverlauf von Patienten mit COVID-19 ([ 49 ]; https://leoss.net ). Die Studie „pooled analysis of neurologic disorders manifesting in intensive care“ (PANDEMIC) der Deutschen Gesellschaft für Neurointensiv- und Notfallmedizin (DGNI) betrachtet die Charakteristika von COVID-19-Patienten mit neurologischen Manifestationen und gleichzeitigem schweren Verlauf ( https://www.dgni.de/forschung/ignite-initiative-klinischer-multizenter-studien.html ).…”