COVID-19 in cancer patients: clinical characteristics and outcome\u2014an analysis of the LEOSS registry

J Schneider ,Philipp Köhler ,Lukas Tometten ,Christiane Piepel ,Sebastian Dolff ,Marie Von Lilienfeld‐Toal ,Gernot Beutel ,Beate Grüner ,Annika Y. Claßen ,Jörg Janne Vehreschild ,Kai Wille ,Uta Merle ,Nora Isberner ,Stefan Borgmann ,Julia Lanznaster ,Clemens Gießen-Jung ,Frank Hanses ,Richard Strauß ,Maximilian Schons ,Silvio Nadalin ,Maria Madeleine Rüthrich

doi:10.1007/s00277-020-04328-4

Abstract

IntroductionSince the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk.Patients and methodsWe retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality.ResultsIn total, 435 cancer patients were included in our analysis. Commonest age category was 76–85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). After adjustments for other risk factors, mortality was comparable.ConclusionComparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions.

Highlights

Introduction Since the early SARSCoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID19
Cancer and noncancer patients appear to have similar infection rates, it is generally assumed that cancer patients are at higher risk for severe COVID-19 and death attributed to COVID-19 [5,6,7,8]
We aimed to describe epidemiological and clinical features and to determine whether cancer patients are at higher risk for severe infection course and COVID-19 mortality compared to non-cancer patients

Summary

Introduction

CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID19. We present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). Cancer and noncancer patients appear to have similar infection rates, it is generally assumed that cancer patients are at higher risk for severe COVID-19 and death attributed to COVID-19 [5,6,7,8]. Numerous studies identified advanced age, male sex, and a high number of comorbidities as

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