ABSTRACT
Introduction: Since the emergence of the novel coronavirus SARS-CoV-2 in December 2019 in Wuhan, cases of the associated disease COVID-19 are seen worldwide. To collect clinical data of the pandemic the international, multicenter Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) registry was established. Here, we present a first description of cancer patients with COVID-19 from LEOSS. Patients and Methods: We retrospectively analyzed a cohort of 283 patients (pts) with cancer and COVID-19 from a total of 1808 pts enrolled between March 6th, 2020, and June 26th, 2020. Baseline characteristics include socio-demographics, comorbidity according to Charlson Comor-bidity Index (CCI), ECOG and outcome of COVID-19. Clinical manifestation of COVID-19 was described in four phases: uncomplicated (asymptomatic/mild symptoms), complicated (need for oxygen supplementation), critical (need for life supporting therapy) and recovery (clinical improvement/discharge). Result(s): Median observational period was 11 (range 0-48) days, median inpatients stay 12.5 (range 0-72) days. Most patients were aged 66 years or older (75.5%), 112 (39.5%) pts were female. Median CCI was 4 (0-15), 46/119 (16.5%) pts had an ECOG >2. Solid tumors were seen in 61%, lymphoma and leukemia in 14.5% and 10.5% respectively. One hundred and seven pts (38%) had an active malignant disease and 76 (27%) had received anti-cancer treatment within the last 3 months. In 181 (64%) pts COVID-19 remained in the uncomplicated phase whereas 93 (33%) pts developed a complicated or critical phase. Sixty-three (22.5%) pts required intensive care, 35 out of 63 needed mechanical ventilation. A total of 79 (28%) pts died, 67 (23.5%) from COVID-19. Median survival was 33 days and worse compared to non-cancer pts (non-cancer pts: med. survival not reached, p-value < 0.001). Conclusion(s): As expected, cancer patients hospitalized for COVID-19 frequently have severe disease and an adverse outcome. To confrm these results, age-and comorbidity adjusted analysis are needed. An update of the analysis will be presented at the DGHO Annual Meeting.
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
Background: Active cancer has been identified as an independent risk factor for severity and mortality in COVID-19. However, direct comparisons of SARS-CoV-2 infected patients (pts) with active and non-active cancers remain scarce. Method(s): We retrospectively analyzed a cohort of pts with cancer with confirmed SARS-CoV-2 infection, enrolled 03/16/2020 - 07/31/2021. Data on demographics, cancer and laboratory findings were collected. Descriptive and subsequent regression analysis was performed. Endpoints were progression to severe COVID-19 and infection-associated mortality. Result(s): In total, 987 pts with cancer (510 active vs 477 non-active) were included in our analysis. Majority was male and > 55 years, with a higher number of elderly pts with non-active cancer. CCI was 4.75 vs 3.85 in pts with active and non-active cancer (p<0.001). Localized solid tumors were reported in 38 vs 79% (p<0.001), metastasized in 37.5 vs 5.5% (p<0.001) and hematological diseases in 37.5 vs 19.5% (p<0.001) pts with active and non-active cancer, respectively. At virus detection, majority of pts showed mild to moderate symptoms, while deterioration to severe COVID-19 was slightly more common in pts with active cancer (19% vs 16%;p=0.284). COVID-19 related mortality was significantly higher in pts with active cancer (24% vs 17.5%, p<0.001). In line, severe cytopenia and an increase of inflammatory markers were common findings in pts with active cancer at baseline, particularly in those who developed severe infection or died. Multivariate analysis revealed that ferritin (14.24 [2.1-96], p=0.006) and CRP (2.85 [1.02-8.02], p=0.046) were associated with severe COVID-19 and infection-related mortality. In pts with non-active cancer, association was seen for ferritin only (4.1 [1.51-11.17], p=0.006). Conclusion(s): Comparing pts with active and non-active cancer, mortality rate was significantly higher in pts with active cancer. Also inflammatory markers were significantly increased assuming higher levels of inflammation may play a role in adverse outcome of COVID-19 in pts with active cancer.