Abstract
ABSTRACTObjective To evaluate the severity of COVID-19 in cancer patients to describe clinical and epidemiological factors associated with poor outcomes (mortality and need of intensive care unit admission or mechanical ventilation).Methods Retrospective data from patients with cancer and laboratory diagnosis of COVID-19, obtained between March 16 and May 29, 2020, were retrieved out of a cancer center database. Data analyzed included patient history, age, sex, comorbidities, types of cancer and anticancer therapy.Results This sample comprised 105 patients aged 18-92 years, 80.9% of whom were females. Dyspnea was the most prevalent initial symptom (30.4%) among patients who died (p<0.0001). Overall, 57.1% of patients had metastatic disease and 60% had poor performance status (Eastern Cooperative Oncologic Group ≥2) at the time of COVID-19 diagnosis. The overall mortality rate was 40.95%. Mortality rates were higher in male patients and those with poor performance status (p<0.0001).Conclusion This cohort is one of the largest Brazilian studies describing clinical and epidemiological features of patients with cancer and concurrent COVID-19. Findings of this study emphasize the vulnerability of cancer patients in the current pandemic, and indicate high mortality from COVID-19 among male cancer patients and cancer patients with poor performance status. This analysis may assist the selection of patients who may benefit from strict isolation and eventual discontinuation of anticancer therapy to reduce exposure to infection.
Highlights
The first case of coronavirus disease 2019 (COVID-19) was reported on December 31, 2019.(1) The genetic sequence of the novel coronavirus was isolated from patients presenting with respiratory infection in Wuhan, China, on January 7, 2020.(2) This new disease became a global pandemic in a matter of weeks
Statistical analyses were performed using software STATA 16. In this retrospective single-center cohort study, the analyses carried out on July 5, 2020 included data from 105 cancer patients diagnosed as COVID 19, at IBCC Oncologia, between March 16 and May 29, 2020
The COVID-19 outbreak became a viral pandemic feared by cancer patients and oncology teams due to the significant negative impacts on cancer treatment.[15]. This report describes clinical and epidemiologic features of cancer patients with COVID-19 seen at a Brazilian cancer center
Summary
The first case of coronavirus disease 2019 (COVID-19) was reported on December 31, 2019.(1) The genetic sequence of the novel coronavirus was isolated from patients presenting with respiratory infection in Wuhan, China, on January 7, 2020.(2) This new disease became a global pandemic in a matter of weeks. In Latin America and the Caribbean, approximately 21% of population is estimated to be at risk of developing severe COVID-19 disease. This region has experienced major outbreaks, with a growing number of cases in Brazil, Peru, Mexico, Chile, Colombia, Panama (and possibly Venezuela and Nicaragua), and increasing concerns regarding testing capacity for COVID-19.(3-6). According to the World Health Organization (WHO), Brazil currently has one of the fastest growing COVID-19 rates worldwide, with 1,864,681 cases and 72,100 deaths, and accounts for more than 55% of total number of reported cases in Latin America and the Caribbean (data from July 14, 2020).(8)
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