First wave mortality data versus full pandemic period from the COVID-CANCER HUIL study

ABSTRACT

Background: Cancer patients are one of the most affected by the current pandemic caused by SARS-CoV-2. Social inequalities influence the incidence rate of this disease, as we have seen in the high incidence in our center. In our study, we asked whether the last covid-19 treatment advances, the capacity for restructuring the health centers and their non-saturation, influences the cancer patients outcomes. Methods: Retrospective review of 189 cancer patients diagnosed in our center with COVID-19 from March 5, 2020 to February 28, 2021. Study data was collected and managed using REDCap. We compared COVID-19 diagnoses in first-wave cancer patients versus the full pandemic period until data cut-off, as well as patient characteristics and mortality rates. Results: Mortality rate 55/189 patients during the entire pandemic period vs 40/85 patients in the first wave (p = 0.03). Median age 72 years (34-95) vs 76 (34-94), 125/189 men in all the period vs 50/85 (p = 0.2). Most frequent histologies lung cancer (72/189 vs 22/85, p = 0.07), colorectal (31/189 vs 19/85, p = 0.23), breast (24/189 vs 10/85, p = 0.82). Staging 113/189 metastatic disease at diagnosis of infection vs 32/85 in first wave (p <0.001). During the 2 subsequent waves in our center, where 104 more patients have been detected, mortality has dropped significantly from the initial 47% to 14.4% in the rest of the period (40/85 vs 15/104, p <0.001), despite having more metastatic involvement in infected patients. Conclusions: In our center, one of the worst hit by the coronavirus crisis in Spain, with a supersaturation of almost 250% in the middle of the first wave, we have verified how the knowledge of the behavior of this disease, improvements in its treatment and a multidisciplinary management in Oncology ward have led to a significant decrease in mortality, going from almost 50% in the first wave to less than 15%, despite having suffered the disease during the two subsequent waves a greater number of patients with metastatic disease. Legal entity responsible for the study Medical Oncology Department, Hospital Universitario Infanta Leonor. Funding: Has not received any funding. Disclosure All authors have declared no conflicts of interest.