ABSTRACT
Background: Community acquired respiratory viruses (CARVs) may cause severe respiratory infections in patients (pts) with cancer. To collect epidemiological and clinical data of CARV-infections the multicentric registry OncoReVir was established. Here, we present a preliminary analysis of pts with cancer infected with CARVs. Method(s): A total of 1,142 pts with cancer and CARV-infection were enrolled between Nov2018 and Jan2022. Most cases were documented for season 17/18 and 18/19. Data on demographics, comorbidities, cancer, CARVs and infection course were collected. Pre-defined endpoints were pneumonia, admission to ICU and mortality. The relationship between cancer-specific factors and outcome was evaluated by bivariate logistic regression. Result(s): The median age was 60 (IQR 50-67) years, 42% of pts were female. Solid tumors were present in < 10%, leukemia, lymphoma and multiple myeloma in 36.5%, 27% and 23%, respectively. 50% had active cancer, 40% had received chemotherapy within the last 3 months. Targeted therapy was reported in 11.5%, high-dose steroids in 16% of pts, 56% were SCTrecipients. Commonly detected CARVs were influenza (39.5%), parainfluenza (18%), respiratory syncytial virus (15%), rhinovirus (14.5%), human metapneumovirus (hMPV, 5.5%), endemic coronavirus (5.5%) and SARSCoV- 2 (2%). Among all CARVs, frequent symptoms were cough, fever, dyspnea and rhinitis. Rates of pneumonia were highest in hMPV (33%) and SARS-CoV-2 (32%), lowest in endemic coronavirus (16%, p=0.334). 8.5% required intensive care, most of them due to COVID-19 (p=0.084). Infection-associated mortality but not rate of pneumonia showed significant differences comparing CARVs. In regression analysis, active cancer was associated with all endpoints: infection-related mortality (4.02 [1.63- 9.88], p=0.002), ICU admission (1.75 [1.07-2.88], p= 0.027) and pneumonia (1.47 [1.1-1.96], 0.009). Conclusion(s): In our cohort, all CARVs could potentially lead to severe disease. Active cancer was an independent risk factor for adverse outcome in pts with cancer and CARV-infection.
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.