Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in Madrid
Background: Cancer patients represent a vulnerable population for COVID-19 illness. We aimed to analyze outcomes of lung cancer patients affected by COVID-19 in a tertiary hospital of a high-incidence region during the pandemic.Methods: We annotated 23 lung cancer patients consecutively diagnosed wi...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.01777/full |
| _version_ | 1830144977070456832 |
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| author | Antonio Calles Antonio Calles María Inmaculada Aparicio Manuel Alva Marianela Bringas Natalia Gutierrez Javier Soto Marta Arregui Victoria Clara Tirado Enrique Luis Álvarez Enrique Luis Álvarez María del Monte-Millán María del Monte-Millán María del Monte-Millán Tatiana Massarrah Tatiana Massarrah Tatiana Massarrah Mar Galera Mar Galera Rosa Álvarez Rosa Álvarez Miguel Martín Miguel Martín Miguel Martín |
| author_facet | Antonio Calles Antonio Calles María Inmaculada Aparicio Manuel Alva Marianela Bringas Natalia Gutierrez Javier Soto Marta Arregui Victoria Clara Tirado Enrique Luis Álvarez Enrique Luis Álvarez María del Monte-Millán María del Monte-Millán María del Monte-Millán Tatiana Massarrah Tatiana Massarrah Tatiana Massarrah Mar Galera Mar Galera Rosa Álvarez Rosa Álvarez Miguel Martín Miguel Martín Miguel Martín |
| author_sort | Antonio Calles |
| collection | DOAJ |
| description | Background: Cancer patients represent a vulnerable population for COVID-19 illness. We aimed to analyze outcomes of lung cancer patients affected by COVID-19 in a tertiary hospital of a high-incidence region during the pandemic.Methods: We annotated 23 lung cancer patients consecutively diagnosed with COVID-19 at our institution (HGUGM; Madrid, Spain) between March 4th, 2020 and May 12th, 2020. Only patients with a confirmatory SARS-CoV-2 RT-PCR were included in the study.Results: All patients had at least 1 COVID-19 related symptom; cough (48%), shortness of breath (48%), fever (39%), and low-grade fever (30%) were the most common. Time from symptoms onset to first positive SARS-CoV-2 PCR was 5.5 days (range 1–17), with 13% of cases needed from a 2nd PCR to confirm diagnosis. There was a high variability on thoracic imaging findings, with multilobar pneumonia as the most commonly found pattern (74%). Main lab test abnormalities were low lymphocytes count (87%), high neutrophil to lymphocyte ratio -NLR- (78%), and elevated inflammatory markers: fibrinogen (91%), c-reactive protein -CRP- (87%), and D-dimer (70%). In our series, hospitalization rate was 74%, 39% of patients developed acute respiratory distress syndrome (ARDS), and the case-fatality rate was 35% (8/23). 87% of patients received anti-viral treatment (87% hydroxychloroquine, 74% lopinavir/ritonavir, 13% azithromycin), 43% corticosteroids, 26% interferon-β, 4% tocilizumab, and 82% of hospitalized patients received anticoagulation. High-oxygen requirements were needed in 39% of patients, but only 1 pt was admitted for invasive MV and was discharged 42 days after admission. Multiple variables related to tumor status, clinical baseline conditions, and inflammation markers were associated with mortality but did not remain statistically significant in a multivariate model. In patients with lung cancer receiving systemic therapy (n = 242) incidence and mortality from COVID-19 were 4.5, and 2.1%, respectively, with no differences found by type of treatment.Conclusions: Lung cancer patients represent a vulnerable population for COVID-19, according to the high rate of hospitalization, onset of ARDS, and high mortality rate. Although larger series are needed, no differences in mortality were found by type of cancer treatment. Measures to minimize the risk of SARS-CoV-2 infection remain key to protect lung cancer patients. |
| first_indexed | 2024-12-17T10:15:06Z |
| format | Article |
| id | doaj.art-aabf02f25c134a9db0c9e8a74afac810 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-17T10:15:06Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-aabf02f25c134a9db0c9e8a74afac8102022-12-21T21:52:55ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-09-011010.3389/fonc.2020.01777582168Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in MadridAntonio Calles0Antonio Calles1María Inmaculada Aparicio2Manuel Alva3Marianela Bringas4Natalia Gutierrez5Javier Soto6Marta Arregui7Victoria Clara Tirado8Enrique Luis Álvarez9Enrique Luis Álvarez10María del Monte-Millán11María del Monte-Millán12María del Monte-Millán13Tatiana Massarrah14Tatiana Massarrah15Tatiana Massarrah16Mar Galera17Mar Galera18Rosa Álvarez19Rosa Álvarez20Miguel Martín21Miguel Martín22Miguel Martín23Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainCiberOnc, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainCiberOnc, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainMedical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, SpainInstituto de Investigación Sanitaria Gregorio Marañón, Madrid, SpainCiberOnc, Madrid, SpainBackground: Cancer patients represent a vulnerable population for COVID-19 illness. We aimed to analyze outcomes of lung cancer patients affected by COVID-19 in a tertiary hospital of a high-incidence region during the pandemic.Methods: We annotated 23 lung cancer patients consecutively diagnosed with COVID-19 at our institution (HGUGM; Madrid, Spain) between March 4th, 2020 and May 12th, 2020. Only patients with a confirmatory SARS-CoV-2 RT-PCR were included in the study.Results: All patients had at least 1 COVID-19 related symptom; cough (48%), shortness of breath (48%), fever (39%), and low-grade fever (30%) were the most common. Time from symptoms onset to first positive SARS-CoV-2 PCR was 5.5 days (range 1–17), with 13% of cases needed from a 2nd PCR to confirm diagnosis. There was a high variability on thoracic imaging findings, with multilobar pneumonia as the most commonly found pattern (74%). Main lab test abnormalities were low lymphocytes count (87%), high neutrophil to lymphocyte ratio -NLR- (78%), and elevated inflammatory markers: fibrinogen (91%), c-reactive protein -CRP- (87%), and D-dimer (70%). In our series, hospitalization rate was 74%, 39% of patients developed acute respiratory distress syndrome (ARDS), and the case-fatality rate was 35% (8/23). 87% of patients received anti-viral treatment (87% hydroxychloroquine, 74% lopinavir/ritonavir, 13% azithromycin), 43% corticosteroids, 26% interferon-β, 4% tocilizumab, and 82% of hospitalized patients received anticoagulation. High-oxygen requirements were needed in 39% of patients, but only 1 pt was admitted for invasive MV and was discharged 42 days after admission. Multiple variables related to tumor status, clinical baseline conditions, and inflammation markers were associated with mortality but did not remain statistically significant in a multivariate model. In patients with lung cancer receiving systemic therapy (n = 242) incidence and mortality from COVID-19 were 4.5, and 2.1%, respectively, with no differences found by type of treatment.Conclusions: Lung cancer patients represent a vulnerable population for COVID-19, according to the high rate of hospitalization, onset of ARDS, and high mortality rate. Although larger series are needed, no differences in mortality were found by type of cancer treatment. Measures to minimize the risk of SARS-CoV-2 infection remain key to protect lung cancer patients.https://www.frontiersin.org/article/10.3389/fonc.2020.01777/fullCOVID-19coronavirusSARS-CoV-2lung cancertocilizumabmultivariate |
| spellingShingle | Antonio Calles Antonio Calles María Inmaculada Aparicio Manuel Alva Marianela Bringas Natalia Gutierrez Javier Soto Marta Arregui Victoria Clara Tirado Enrique Luis Álvarez Enrique Luis Álvarez María del Monte-Millán María del Monte-Millán María del Monte-Millán Tatiana Massarrah Tatiana Massarrah Tatiana Massarrah Mar Galera Mar Galera Rosa Álvarez Rosa Álvarez Miguel Martín Miguel Martín Miguel Martín Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in Madrid Frontiers in Oncology COVID-19 coronavirus SARS-CoV-2 lung cancer tocilizumab multivariate |
| title | Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in Madrid |
| title_full | Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in Madrid |
| title_fullStr | Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in Madrid |
| title_full_unstemmed | Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in Madrid |
| title_short | Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in Madrid |
| title_sort | outcomes of covid 19 in patients with lung cancer treated in a tertiary hospital in madrid |
| topic | COVID-19 coronavirus SARS-CoV-2 lung cancer tocilizumab multivariate |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.01777/full |
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