COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

L, Lee; Cazier, Jean‐Baptiste; Angelis, Vasileios; Arnold, Roland; Bisht, Vartika; Campton, Naomi; Chackathayil, Julia; Cheng, Vinton W.T.; Curley, Helen; Fittall, Matthew; Freeman-Mills, Luke; Gennatas, Spyridon; Goel, Ankit; Hartley, Simon; Hughes, D.J.; Kerr, David; Lee, Alvin; Lee, Rebecca; McGrath, Sophie; Middleton, Christopher; Murugaesu, Nirupa; Newsom-Davis, Thomas; Okines, Alicia; Olsson‐Brown, Anna; Palles, Claire; Pan, Yi; Pettengell, Ruth; Powles, Thomas; Protheroe, Emily; Purshouse, Karin; Sharma-Oates, Archana; Sivakumar, Shivan; Smith, Ashley J.; Starkey, Thomas; Turnbull, Chris D.; Várnai, Csilla; Yousaf, Nadia; Kerr, Rachel; Middleton, Gary

doi:10.1016/s0140-6736(20)31173-9

Cited by 1,081 publications

(1,586 citation statements)

References 12 publications

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“…Contrasting conclusions were obtained in a recent prospective observational study performed in the United Kingdom amidst 800 patients with a diagnosis of cancer and symptomatic COVID-19: global mortality was 28% and signi cantly higher risk was observed for males, with advancing age and in presence of comorbidities such as hypertension and cardiovascular diseases [24]. Active treatments, including systemic therapy and radiotherapy, within 4 weeks before SARS-Cov-2 positive RT-PCR had no signi cant effect on mortality from COVID-19.…”

Section: Covid-19 Impact On the Staffcontrasting

confidence: 71%

“…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],…”

Section: Covid-19 Impact On the Staffmentioning

confidence: 70%

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

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

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Abstract Background: Coronavirus Disease 2019 (COVID-19) pandemic had an overwhelming impact on healthcare worldwide. Outstandingly, the aftermath on neoplastic patients is still largely unknown, and only isolated cases of COVID-19 during radiotherapy have been published. We will report the two-months experience of our Department, set in Lombardy “red-zone”.Methods: data of 402 cancer patients undergoing active treatment from February 24 to April 24, 2020 were retrospectively reviewed; several indicators of the Department functioning were also analyzed.Results: dedicated measures allowed an overall limited reduction of the workload. Decrease of radiotherapy treatment number reached 17%, while the number of administration of systemic treatment and follow up evaluations kept constant. Conversely, new treatment planning faced substantial decline. Considering the patients, infection rate was 3.23% (13/402) and mortality 1.24% (5/402). Median age of COVID-19 patients was 69.7 years, the large majority were male and smokers (84.6%); lung cancer was the most common tumor type (61.5%), 84.6% of subjects were stage III-IV and 92.3% had comorbidities. Remarkably, 92.3% of the cases were detected before March 24. Globally, only 2.5% of ongoing treatments were suspended due to suspect or confirmed COVID-19 and 46.2% of positive patients carried on radiotherapy without interruption. Considering only the last month, infection rate among patients undergoing treatment precipitated to 0.43% (1/232) and no new contagions were reported within our staff. Conclusions: although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during SARS-Cov-2 pandemic by endorsing consistent preventive measures.

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Section: Covid-19 Impact On the Staffcontrasting

confidence: 71%

Section: Covid-19 Impact On the Staffmentioning

confidence: 70%

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

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

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“…Some retrospective study did not show any signi cant association between recent cancer treatment and mortality, as with our study [9][10][11][12]. However, one retrospective study in China reported a higher likelihood of experiencing severe events in patients who received antitumor treatment within 14 days of COVID-19 diagnosis [5].…”

Section: Discussionsupporting

confidence: 59%

Characteristics and outcomes of coronavirus disease 2019 (COVID-19) patients with cancer: A single-center retrospective observational study in Tokyo, Japan

Nakamura

Kanemasa

Atsuta

et al. 2020

Preprint

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Abstract BackgroundAlthough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an international outbreak of coronavirus disease 2019 (COVID-19), data on the clinical characteristics of COVID-19 patients with cancer are limited. This study aimed to evaluate the clinical characteristics and outcomes including mortality and viral shedding period in COVID-19 patients with cancer in Japan.MethodsWe retrospectively analyzed 32 patients with a history of cancer who were referred to our hospital between January 31, 2020 and May 25, 2020. We evaluated the association between clinical outcomes and potential prognostic factors using univariate analyses.ResultsThe median age was 74.5 (range, 24–90) years and 22 patients (69%) were men. A total of 11 patients (34%) died. Our analyses demonstrated that the mortality was significantly associated with lymphocyte count, albumin, lactate dehydrogenase, serum ferritin, and C-reactive protein on admission. The median period between illness onset and the first effective negative SARS-CoV-2 PCR result was 22 days (interquartile range, 18–25) in survivors. Of four patients with hematological malignancy who developed COVID-19 within the rest period of chemotherapy, three died and the other patient, who received bendamustine plus rituximab therapy, had the longest duration of viral shedding (56 days).ConclusionOur study suggested that the risk factors for mortality previously reported in general COVID-19 patients, including lymphocytopenia, were also effective in cancer patients. Patients who received cytotoxic chemotherapy recently or were treated with chemotherapy, which can lead to lymphocyte reduction, had poor prognosis and prolonged periods of viral shedding.

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“…It has been seen in China that patients with cancer deteriorated more rapidly than patients without cancer 16 . In contrast, the UK Coronavirus Cancer Monitoring Project (UKCCMP) concluded that CT given within 4 weeks before confirmed COVID‐19 is not a significant contributor to a more severe disease or a predictor of death from COVID‐19, compared with patients with cancer who have not received CT in that period 17 …”

Section: Discussionmentioning

confidence: 99%

Impact of the pandemic on cancer care: Lessons learnt from a rural cancer center in the first 3 months

Deshmukh

Naik

Zade

et al. 2020

Journal of Surgical Oncology

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Introduction The COVID‐19 outbreak and the subsequent declaration of pandemic was an unprecedented event, which created different complex situations for treatment of cancer patients. A critical assessment of the response to this calamity and its impact on healthcare workers (HCWs) and patient care in a dedicated cancer hospital is analyzed. Site of Study Indrayani Cancer Hospital, Alandi, Pune, India. Materials and Methods Due to the pandemic, standard operating protocols were decided on for each department. Analysis of the impact on healthcare was done by comparing the number of patients taking treatment in the lockdown period in India with the previous year's data in the same corresponding period in all three departments. The impact of COVID infection on the HCW and its repercussions were analyzed. Results There was a marked decrease in the total number of patients during the lockdown period. The most affected department was surgical oncology. None of our patients contracted COVID‐19, but one HCW was found to be positive. Conclusion Strict adherence to protocols along with the support of the government authorities can prevent the spread of this virus thus providing optimal patient outcomes. The treatment of patients with cancer should not be delayed, even in times of a pandemic.

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COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

Cited by 1,081 publications

References 12 publications

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

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

Characteristics and outcomes of coronavirus disease 2019 (COVID-19) patients with cancer: A single-center retrospective observational study in Tokyo, Japan

Impact of the pandemic on cancer care: Lessons learnt from a rural cancer center in the first 3 months

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