Defining the true impact of coronavirus disease 2019 in the at-risk population of patients with cancer.
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Date
2020-09-01Author
Angelis, V
Tippu, Z
Joshi, K
Reis, S
Gronthoud, F
Fribbens, C
Okines, A
Stanway, S
Cottier, E
McGrath, S
Watkins, D
Noble, J
Bhosle, J
Gerlinger, M
Hamid, I
Soliman, H
Nenclares, P
Jones, R
Harrington, K
Gennatas, S
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: In light of the coronavirus disease 2019 (COVID-19) pandemic, cancer centres in the United Kingdom and Europe re-organised their services at an unprecedented pace, and many patients with cancer have had their treatments severely disrupted. Patients with cancer were considered at high risk on sparse evidence, and despite a small number of emerging observational studies, the true incidence and impact of COVID-19 in the 'at-risk' population of patients with cancer is yet to be defined. METHODS: Epidemiological and clinical data were collected prospectively for patients attending the Royal Marsden Hospital and three network hospitals between March 1st and April 30th 2020 that were confirmed to have Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. Significance of clinical and pathological characteristics was assessed using the Fisher's exact test and Wilcoxon rank sum test, whilst univariate and multivariate logistic regression models were used to further assess risk. The number of patients attending in March/April 2020 for face-to-face attendances was also extracted. FINDINGS: During the 2-month study period, 867 of 13,489 (6.4%) patients met the criteria leading to swab testing. Of the total at-risk population, only 113 of 13,489 (0.84%) were swab positive, 101 of 13,489 (0.75%) required hospital admission and 29 of 13,489 (0.21%) died of COVID-19. Of the patients that attended the hospital to receive cytotoxic chemotherapy alone or in combination with other therapy, 59 of 2001 (2.9%) were admitted to the hospital for COVID-19-related issues and 20 of 2001 (1%) died. Of the patients that collected targeted treatments, 16 of 1126 (1.4%) were admitted and 1 of 1126 (0.1%) died. Of the 11 patients that had received radiotherapy, 6 of 1042 (0.6%) required inpatient admission and 2 of 1042 (0.2%) died. INTERPRETATIONS: Administration of systemic anticancer therapy appears to be associated with a modest risk of severe COVID-19 infection. Based on this snapshot taken as the first wave of COVID-19 hit our practice, we conclude that continuation of active cancer treatment, even in the palliative setting, is appropriate.
Collections
Subject
Humans
Pneumonia, Viral
Coronavirus Infections
Neoplasms
Antineoplastic Agents
Protein Kinase Inhibitors
Hospitalization
Radiotherapy
Incidence
Mortality
Multivariate Analysis
Logistic Models
Risk Factors
Adult
Aged
Aged, 80 and over
Middle Aged
Female
Male
Cyclin-Dependent Kinase 4
Cyclin-Dependent Kinase 6
Young Adult
Pandemics
Poly(ADP-ribose) Polymerase Inhibitors
United Kingdom
Betacoronavirus
Antineoplastic Agents, Immunological
COVID-19
SARS-CoV-2
Research team
Translational Oncogenomics
Language
eng
Date accepted
2020-06-24
License start date
2020-09
Citation
European journal of cancer (Oxford, England : 1990), 2020, 136 pp. 99 - 106
Publisher
ELSEVIER SCI LTD