509P COVID-19 disease among lung cancer (LC) patients: Data from a real-life prospective multicentric study

Abstract

KBP-2020-CPHG is a prospective cohort study that included all consecutive patients diagnosed with lung cancer (LC) admitted in 2020, in nonacademic public hospital pulmonology or oncology units. This study provides a unique opportunity to prospectively study the incidence rate of COVID and associated factors in LC patients. All new LC diagnosed between 01/01 and 12/31/2020 in non-academic public hospital pulmonology or oncology units were included. Data on COVID diagnosis (PCR test, serology, CT-scan) were collected. Only COVID diagnosed in 2020 after LC diagnosis were considered in this analysis. Incidence rate ratios were measured in different subgroups of patients (multivariate Poisson regression including age, sex, smoking status, histological type, PS, tumour grade and chemotherapy before COVID) and a survival analysis was performed (Cox regression with COVID as a time-dependent covariate). A total of 8,999 patients were included by 82 centers. Data on COVID were completed for 8,474: 308 patients had COVID after LC diagnosis, in 2020. COVID incidence measured by number of case / 100py from LC diagnosis was 7.5 [6.6-8.5]. Incidence rate ratio (IRR) was statistically larger in patients with small cell LC (IRR 2.01[1.37:2.91] P<0.001) or with squamous LC (IRR 1.42 [1.03:1.94] P=0.028) (Table). PS 2 or 3, and stage III or IV, and the absence of chemotherapy were associated with increased incidence. Age and smoking status had no significant effect on IRR. COVID was significantly associated with shorter survival time (HR 3,24; [ 2.69:3.90] P<0.001).Table: 509PIncidence rate per 100 patients-years (95% CI)MultivariateIRR195% CI1p-valueGender F6.2 (4.9 ; 7.7)—— M8.3 (5.0 ; 13.6)1.300.99, 1.740.068Histology Adenocarcinoma & others6.3 (5.3 ; 7.4)—— Small cells11.4 (6.8 ; 18.6)2.011.37, 2.91<0.001 Squamous LC9.2 (5.8 ; 14.4)1.421.03, 1.940.028Stage at diagnosis I4.2 (2.4 ; 6.5)—— II5.3 (1.6 ; 16.3)1.410.73, 2.770.3 III7.6 (2.6 ; 21.5)2.201.24, 4.100.009 IV8.6 (3.1 ; 23,5)2.181.29, 3.940.006Chemotherapy before COVID Yes6.4 (5.4 ; 7.6)—— No9.5 (6.2 ; 14.3)2.041.51, 2.76<0.0011IRR = Incidence Rate Ratio, CI = Confidence Interval. Open table in a new tab 1IRR = Incidence Rate Ratio, CI = Confidence Interval. COVID incidence in lung cancer was associated with histology type, stage and PS. COVID is a strong risk factor of mortality.