ABSTRACT
Background: Several reports have observed that cancer patients who recently underwent chemotherapy or surgeryhad a higher risk of severe events compared with patients without cancer. Limited data is available on outcomes inspecific cancer types, as well as the impact of non-cytotoxic systemic treatment, such as targeted therapy andhormonal therapy on severe outcomes. We aim to identify whether active treatment impacts severe outcomes (rateof hospitalization, ICU admission, intubation, and death) in breast cancer patients. Methods: We conducted amulticenter study in the state of Louisiana, throughout the Ochsner Health System, in both tertiary and non-tertiarycenters. Patients must carry a diagnosis of breast cancer, and have a completed SARS-CoV-2 test between March1st and April 30th, 2020. Chi-squared and Fisher's exact tests were performed to compare the proportion of patientsexperiencing severe outcomes between treatment groups. Results: As of April 30, 2020, a total of 70 patients withbreast cancer who had a positive SARS-COV-2 test were identified. Median age 64.5, median BMI 30.8, 62.9%(n=44) black, 27.1% (n=19) current/former smokers, HTN (n=52) and DM2 (n=22) were the most commoncomorbidities, and 12.9% (n=9) of patients had stage IV disease. Of these patients, 58.6% (n=41) were on hormonaltreatment, and another 12.9% (n=9) were receiving other forms of systemic therapy (cytotoxic chemotherapy ortargeted therapy). In terms of severe outcomes, 32.9% (n=23) of patients required hospitalization, 8.6% (n=6)required ICU admission with 7.1% (n=5) patients requiring intubation, 11.4% (n=8) of patients died. There was not astatistical difference in rate of severe outcomes (rate of hospitalization, ICU admission, intubation, and death)among breast cancer patients receiving active treatment (chemotherapy, targeted therapy, or hormonal therapy) vs those receiving no active treatment. There was also no difference in terms of severe outcomes by race. Conclusion:With an ongoing global COVID-19 pandemic, it is important to identify how the treatment and management ofcancer impacts COVID-19 outcomes. This small cohort does not identify active treatment as a risk factor forincreased rate of severe outcomes in patients with breast cancer. Further analyses describing impact of specifichormonal and chemotherapy regimens on risk of hospitalization and death will be completed by time of presentation.
ABSTRACT
Background: Early reports on cancer patients infected with COVID-19 have suggested a high risk of hospitalizationand death compared to the general population. Limited data are available on outcomes in specific cancer types. Weaim to identify whether hormonal treatment impacts severe outcomes (rate of hospitalization, ICU admission, intubation, and death) in prostate cancer patients. Methods: We conducted a multicenter study in the state of Louisiana, throughout the Ochsner Health System, inboth tertiary and nontertiary centers. Patients must carry a diagnosis of prostate cancer and have a completedSARS-CoV-2 test between March 1st and April 30th, 2020. Chi-squared and Fisher's exact tests were performed tocompare the proportion of patients experiencing severe outcomes between treatment groups. Results: As of April 30, 2020, a total of 56 patients with prostate cancer who had a positive SARS-COV-2 test wereidentified. Median age 69, median BMI 28.8, 78.6% (n=44) black, 58.9% (n=33) current/former smokers, HTN, DM2, and CKD were the most common comorbidities, and 12.5% (n=7) of patients had stage IV disease. Of thesepatients, 26.8% (n=15) were on hormonal treatment (received within 90 days of COVID+ test). In terms of severeoutcomes, 58.9% (n=33) of patients required hospitalization, 17.9% (n=10) required ICU admission with 14.3%(n=8) patients requiring intubation, and 23.2% (n=13) of patients died. There was no statistical difference in rate ofsevere outcomes (rate of hospitalization, ICU admission, intubation, and death) among prostate cancer patientsreceiving hormonal therapy vs. those receiving no hormonal therapy. Conclusion: With an ongoing global pandemic of COVID-19, it is important to identify characteristics leading toincreased risk of severe events in cohorts of cancer patients. This small cohort does not identify hormonal therapyas a risk factor for increased rate of severe outcomes in patients with prostate cancer. Further analyses describingimpact of specific hormonal regimens on risk of hospitalization and death will be completed by time of presentation.
ABSTRACT
Introduction: While many data have been emerging regarding the outcomes of cancer patients infected with SARS-CoV-2 and their increased risk of mortality, emphasis on patients with hematologic malignancies and how they havebeen affected during this pandemic is lacking. Louisiana, particularly New Orleans, one of the pandemic epicenters, has a higher-than-average cancer diagnosis rate of multiple myeloma as well as cancer-related deaths. OchsnerCancer Institute was fortunately prepared for the crisis, which allowed our center to continue taking care of bothinpatients and outpatients as needed during the pandemic. Hence, we accumulated ample data among cancerpatients and the effects of COVID-19. Here we provide novel initial mortality data on multiple myeloma patientsinfected with SARS-CoV-2. Methods: Our retrospective, electronic medical record review included 15 patients with a history of multiplemyeloma who tested positive for SARS-CoV-2 PCR from March 1st to April 30th, 2020. Medical records werereviewed for inpatient/outpatient status of infection, outcome of infection, multiple myeloma disease and treatmenthistory, and history of autologous stem cell transplant. Results: Out of the 15 patients infected, there were 6 deaths (40%). A total of 11 patients were on active treatment, including all 6 patients who died (54.5%), though active treatment did not appear to be a significant risk factor whencompared to off-therapy patients (p=.103). Patients older than 65 years seem to be at increased risk of death whencompared to patients less than 65 years of age (p=.011). Hospitalized patients were more likely to succumb to infection compared to non-hospitalized patients (p=.044). Of the 15 patients, 4 had a history of autologous stem celltransplant and this was not found to affect mortality (p=.103). Chronic kidney disease was present in 7 patients anddid not appear to impact mortality (p=.315). Of these (n=9), 7 patients had hypogammaglobulinemia and 5 of thesepatients died (71.4%). Overall, 5 of the 6 patients who died were found to have hypogammaglobulinemia (the 6thdeath did not have immunoglobulins eligible for review). However, the presence of hypogammaglobulinemia did notappear to increase mortality overall (p=.167). Conclusion: Patients older than 65 years of age with a history of multiple myeloma seem to be at risk of death fromCOVID-19. Interestingly, a history of autologous stem cell transplant did not appear to affect mortality. While thepresence of hypogammaglobulinemia did not affect mortality, its overwhelming finding in the patients who diedwarrants further discussion in the future. Larger studies are needed to expand on these findings and uncover furthercharacteristics to help stratify at-risk patients in the future.