ABSTRACT
BACKGROUND: Currently there are no reported series determining the Covid-19 infected lung cancer patient´s characteristics and outcome that allow us to clarify strategies to protect our patients. In our study we determine whether exists differences in cumulative incidence and severity of Covid-19 infection between lung cancer patients visiting our Medical Oncology department and the reference population of our center (320,000 people), in the current epicenter of the pandemic in Europe (Madrid, Spain). We also describe clinical and demographic factors associated with poor prognosis and Covid-19 treatment outcomes. PATIENTS AND METHODS: We retrospectively reviewed 1878 medical records of all Covid-19 patients who were admitted at Hospital Universitario Infanta Leonor of Madrid between March 5, 2020 and April 7, 2020, in order to detect cumulative incidence of Covid-19 in lung cancer patients. We also described Covid-19 treatment outcome, mortality and associated risk factors using univariate and multivariate logistic regression analysis. RESULTS: 17/1878 total diagnosis in our center had lung cancer (0.9 %) versus 1878/320,000 of the total reference population (p = 0.09). 9/17 lung cancer patients with Covid-19 diagnosis died (52.3 %) versus 192/1878 Covid-19 patients in our center (p < 0.0001). Dead lung cancer patients were elderly compared to survivors: 72 versus 64.5 years old (p = 0.12). Combined treatment with hydroxychloroquine and azithromycin improves the outcome of Covid-19 in lung cancer patients, detecting only 1/6 deaths between patients under this treatment versus others treatment, with statistical significance in the univariate and multivariate logistic regression (OR 0.04, p = 0.018). CONCLUSIONS: Lung cancer patients have a higher mortality rate than general population. Combined hydroxychloroquine and azithromycin treatment seems like a good treatment option. It is important to try to minimize visits to hospitals (without removing their active treatments) in order to decrease nosocomial transmission.
Subject(s)
Coronavirus Infections/mortality , Cross Infection/prevention & control , Lung Neoplasms/mortality , Pandemics , Pneumonia, Viral/mortality , Aged , Aged, 80 and over , Azithromycin/therapeutic use , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Coronavirus Infections/virology , Cross Infection/complications , Cross Infection/drug therapy , Cross Infection/virology , Drug Combinations , Female , Humans , Hydroxychloroquine/therapeutic use , Logistic Models , Lung Neoplasms/complications , Lung Neoplasms/drug therapy , Lung Neoplasms/virology , Male , Middle Aged , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Pneumonia, Viral/virology , Prognosis , SARS-CoV-2 , Spain/epidemiologyABSTRACT
The incidence of cancer in children and adults with Down’s syndrome has a clearly differentiated presentation pattern with a higher frequency of lymphomas and leukaemias and a lower frequency of solid tumours. The incidence of breast cancer has especially decreased. In our setting, COVID-19 mortality in cancer patients has greatly increased. We present the case of a patient with Down’s syndrome, breast cancer and COVID-19. Resumen La incidencia de cáncer en niños y adultos con Síndrome de Down tiene un patrón de presentación claramente diferenciado con mayor frecuencia de linfomas y leucemias y menor de tumores sólidos. La incidencia de cáncer de mama está especialmente disminuida. En nuestro medio, la mortalidad por COVID-19 en pacientes con cáncer está incrementada en sobremanera. Presentamos el caso de una paciente con síndrome de Down, cáncer de mama y COVID-19.