COVID-19 in cancer patients: Risk factors for the development of severe clinical event (SCE)

ABSTRACT

Background: Some studies have suggested a higher risk of respiratory complications related to COVID-19 (C-19) in cancer patients (pts), but there is a lack of knowledge concerning the outcomes and prognostic factors. We evaluated whether various factors can predict a more serious C-19 infection. Methods: We conducted a retrospective study including 51 pts diagnosed of C-19 between March 10 and April 7, 2020. All pts present tumor disease at diagnosis of C-19 advanced disease, neoadjuvant treatment (ttm) or maintenance ttm after definitive chemoradiotherapy. It has been evaluated whether certain factors may present an increased risk for the development of a SCE, defined as death, the need of high oxygen flow (FiO2≥50%), non-invasive or invasive mechanical ventilation or Intensive Care Unit admission. These factors have been age, ECOG, ttm line, type of ttm, time from last ttm to C-19 diagnosis, smoke, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, cardiopathy, body mass index, fever, cough, dyspnea, myalgia, gastrointestinal symptoms, infiltrates in chest radiography, CURB65 ≥1, creatine phosphokinase, lactate dehydrogenase and D-Dimer elevated, lymphopenia and PaO2/FiO2 <300 mmHg. Results: At the time of the data cut-off on May 16 2020, we have collected 51 cancer pts. Most of them were men (61%) with a median age of 68 years (range 19-86). Lung cancer was the most frequent type of cancer (22%), and the most common ttm was chemotherapy (51%). Eighteen pts (35%) developed a SCE, with 13 deaths (25%). Only dyspnea and PaO2/FiO2 <300 mmHg showed an increased risk to develop a SCE. [Formula presented]. Conclusions: Despite our retrospective analysis and the limited number of pts, we conclude that advanced cancer pts receiving antitumoral ttm have a higher risk for the development of SCE when considering the presence of PaO2/FiO2 <300 mmHg and dyspnea on admission. Therefore, it is crucial to screen for C-19 infection in any cancer patient who reports dyspnea, given the potential risk of poor evolution. Legal entity responsible for the study Oncology Department, Hospital Universitario Ramon y Cajal, Madrid. Funding: Has not received any funding. Disclosure All authors have declared no conflicts of interest.