Presenting features and early mortality from SARS-CoV-2 infection in cancer patients during the initial stage of the COVID-19 pandemic in Europe

Aguilar-Company, Juan; Avanzi, Gian Carlo; Bellan, Mattia; Benafif, Sarah; Biello, Federica; Bower, Mark; Bruna, Riccardo; Brunet, Joan; Carbó, Anna; Carmona, Carme; Castello, Luigi Mario; Chopra, Neha; Cruz, Claudia Andrea; D'avanzo, Francesca; Evans, Joanne S.; Ferrante, Daniela; Gaidano, Gianluca; Galazi, Myria; Garcia-Fructuoso, Isabel; Gennari, Alessandra; Lee, Alvin J.X.; Marco-Hernández, Javier; Mollà, Meritxell; Newsom-Davis, Thomas; Ottaviani, Diego; Patriarca, Andrea; Pinato, David J.; Pirisi, Mario; Prat, Aleix; Pria, Alessia D.; Reyes, Roxana; Rizzo, Gianpiero; Ruiz-Camps, Isabel; Sainaghi, Pier Paolo; Scotti, Lorenza; Seguí, Elia; Sharkey, Rachel; Sng, Christopher C.T.; Tabernero, Josep; Universitat Autònoma de Barcelona; Wong, Yien Ning Sophia

Presenting features and early mortality from SARS-CoV-2 infection in cancer patients during the initial stage of the COVID-19 pandemic in Europe

Abstract

Funding: D.J.P. is supported by grant funding from the Wellcome Trust Strategic Fund (PS3416) and acknowledges grant support by the Cancer Treatment and Research Trust (CTRT) as well as infrastructural support by the Cancer Research UK Imperial Centre. GG is supported by the AIRC 5 × 1000 Grant, No. 21198, Associazione Italiana per la Ricerca sul Cancro Foundation, Milan, Italy. A.G. is supported by the AIRC IG grant, No. 14230, Associazione Italiana per la Ricerca sul Cancro Foundation, Milan, Italy. A.G., G.G., G.C.A., L.M.C., M.B., P.P.S., M.P. from the University of Piemonte Orientale acknowledge support from the UPO Aging Project.We describe the outcomes in cancer patients during the initial outbreak of the COVID-19 in Europe from the retrospective, multi-center observational OnCovid study. We identified 204 cancer patients from eight centers in the United Kingdom, Italy, and Spain aged > 18 (mean = 69) and diagnosed with COVID-19 between February 26th and April 1st, 2020. A total of 127 (62%) were male, 184 (91%) had a diagnosis of solid malignancy, and 103 (51%) had non-metastatic disease. A total of 161 (79%) had > 1 co-morbidity. A total of 141 (69%) patients had > 1 COVID-19 complication. A total of 36 (19%) were escalated to high-dependency or intensive care. A total of 59 (29%) died, 53 (26%) were discharged, and 92 (45%) were in-hospital survivors. Mortality was higher in patients aged > 65 (36% versus 16%), in those with > 2 co-morbidities (40% versus 18%) and developing > 1 complication from COVID-19 (38% versus 4%, p = 0.004). Multi-variable analyses confirmed age > 65 and > 2 co-morbidities to predict for patient mortality independent of tumor stage, active malignancy, or anticancer therapy. During the early outbreak of SARS-CoV-2 infection in Europe co-morbid burden and advancing age predicted for adverse disease course in cancer patients. The ongoing OnCovid study will allow us to compare risks and outcomes in cancer patients between the initial and later stages of the COVID-19 pandemic