Ninety‐day mortality and clinical outcomes of patients with solid tumours and COVID‐19 infection during the first pandemic outbreak in Catalonia, Spain: A multicentre retrospective study

Abstract

To describe the clinical outcomes and risk factors for 90‐day mortality in patients with solid tumours (ST) and coronavirus disease 2019 (COVID‐19) during the first outbreak in Catalonia. This is a multicentre retrospective study including adults with ST and COVID‐19 confirmed by real time reverse transcription polymerase chain reaction between 13 March and 30 April 2020. Clinical and survival data were collected. Follow‐up ended on 30 July 2020. Multivariate and survival analysis were performed. A hundred and fifteen patients were included. In all, 42.6% had advanced disease and were receiving anticancer treatment; 7% were admitted to the ICU and 22.6% died during hospitalisation. Thirty‐day mortality was 27.8%, which increased to 33.9% at 90 days. Ninety‐day mortality was associated with current smoker status (hazard ratio [HR]: 2.91, 95% CI [confidence interval]: 1.03‐8.33, P = .044), baseline ECOG‐PS 2 to 3 (HR: 3.88, 95% CI: 1.77‐8.46, P < .001]), dyspnoea (HR: 3.02, 95% CI: 1.31‐6.96, P = .009), a respiratory rate ≥ 24 (HR: 2.24, 95% CI: 1.02‐4.92, P = .046) and sepsis (HR: 3.97, 95% CI: 1.78‐8.88, P < .001). Of the 76 survivors, 73.6% had a follow‐up visit. Of those, 33.9% had their cancer controlled and 23.2% had progressed. Thirty‐five survivors were receiving anticancer treatment before COVID‐19 diagnosis though 14 had to discontinue the treatment. Eight survivors without previous anticancer therapy started therapy. The median time to start anticancer therapy after COVID‐19 was 45 days (interquartile range: 28‐61). In conclusion, 90‐day mortality in patients with ST and COVID‐19 was 33.9%; current smoker status, poor ECOG‐PS, dyspnoea, respiratory rate ≥24 and sepsis were independent risk factors for mortality; and survivors did not restart their anticancer treatment until 1.5 months after COVID‐19 diagnosis.