ABSTRACT
Background: SARS-CoV-2 is a novel coronavirus that has been responsible for the largest pandemic in the last century: COVID-19. This disease has widely affected Spain with a high lethality in ancient patients (pts) and with comorbidities. Oncological pts were not an exception. Methods: We evaluated the association between COVID-19 mortality and clinical/laboratory/radiological parameters in cancer pts from March to April 2020 at our institution. Past medical history and COVID-19-related parameters (symptoms, laboratory/x-ray findings and treatments) were retrospectively collected. Univariate analysis (UA) has been done using Fisher exact and U-Mann-Withney test for qualitative and quantitative variables, respectively. Multivariant analysis (MA) has been done using logistic regression. Results: Forty three hospitalized pts were diagnosed with COVID-19;30 pts (69.8%) were symptomatic on admission and 13 pts (30.2%) were hospital-acquired cases. Median age was 68.8 ± 7.8 years. Most part of the pts had gastrointestinal (GI) (13;30.2%), thoracic (Tx) (12;27.9%) and breast (6;14%) cancer. A higher prevalence of Tx tumours compared to our new pts prevalence is observed (9%). Fever was the most common symptom (27;62.8%) and bilateral pneumonia was observed in 24 pts (55.8%). SARS-Co-V-2 PCR was positive in 34 pts (79.1%). Hydroxychloroquine was administered in 35 pts (81.4%), steroids and antiretrovirals in 19 pts (44.1%) and tocilizumab in 12 pts (27.9%). Mortality rate due to COVID-19 was 30.23% (13 pts) and 8 pts could resume oncological treatment. Hypertension (HTA) and previous daily steroids given during last month before admission;as well as performance status, fever, Curb-65, SOFA score and D-Dimer (DD) at admission were associated with COVID-19 mortality in UA. Similarly, high flow oxygen requirements during hospitalization and DD at 72 hours are predictors of mortality. HTA [OR: 8.3 (1-5-70.1)], steroids [OR: 10.7 (1.3 – 143.8)] and fever [OR: 0.09 (0.01 – 0.55)]were also associated in MA. Conclusions: COVID-19 showed a relative higher incidence in pts with Tx and GI tumours. Some clinical and laboratory parameters were found to be predictive factors for mortality as previously reported in non-cancer pts. Further investigations with larger number of pts are needed. Legal entity responsible for the study: HM Hospitales. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
ABSTRACT
Background: SARS-CoV-2 is a novel coronavirus that has been responsible for the largest pandemic in the last century: COVID-19. Some patients (pts) develop a severe pneumonia with higher mortality rate. Oncological population could be at higher risk. Methods: We evaluated the association between COVID-19 severe pneumonia and clinical/laboratory/radiological parameters in cancer pts admitted to our institution from March to April 2020. We considered a severe pneumonia if the patient required more than 5L supplemental oxygen. Past medical history and COVID-19-related parameters (such as symptoms, laboratory/x-ray findings and specific treatments for the COVID-19) were retrospectively collected. Univariate and multivariate analysis have been done using logistic regression. Results: Forty-three cancer pts were hospitalized with COVID-19 diagnosis;27 pts (62.8%) were male. Median age was 68.8 ± 7.8 years. Most part of the pts had gastrointestinal (13;30.2%), thoracic (12;27.9%) and breast (6;14%) cancer. 33 pts (83.7%) presented pneumonia, which was bilateral in 24 pts (55.8%). Median basal saturation of oxygen (O2) was 92% (87-94.5). Severe pneumonia was observed in 23 pts (53.5%). In these patients, the most common symptoms were dyspnea (16;69.6%), cough (14;60.9%) and fever (11;47.8%). Hydroxychloroquine was administered in 20 pts (87%), antiretrovirals in 14 pts (60.9%), steroids in 13 pts (56.5%) and tocilizumab in 9 pts (39%). Mortality rate due to COVID-19 was 84.6% in pts with severe pneumonia versus 15.4% in the rest of patients (p=0.03). Thoracic cancer and diabetes were associated with severe pneumonia development in univariate analysis. Thoracic cancer [OR: 12.0 (1.8 – 246.5)] was also associated in multivariate analysis. Conclusions: Severe pneumonia was frequent in cancer patients with COVID-19 admitted to our institution and was associated with a high mortality rate. Thoracic tumours were found to be a risk factor for developing severe pneumonia. Further investigations with larger number of pts are needed. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.