Systemic Treatment of Cancer Patients during SARS-CoV-2 Pandemic

The SARS-CoV-2 pandemic has a significant influence on the functioning of every aspect of health care, including oncology. There is no doubt, the highest risk of complication or death due to SARS-CoV-2 infection is observed in elderly and patients with comorbidities [1]. Since the majority of cancers (>60%) is diagnosed in patients 65 years of age, cancer patients represent the population at high risk of COVID-19-related complications. Available literature data on the course of COVID-19 in cancer patients are scarce and comprise of two papers and 46 patients [2,3the clinical characteristics of COVID-19-infected cancer patients are largely unknown. PATIENTS AND METHODS In this retrospective cohort study, we included cancer patients with laboratory confirmed COVID-19 from three designated hospitals in Wuhan, China. The clinical data were collected from medical records from Jan 13, 2020, to Feb 26, 2020. Univariate and multivariate analyses were performed to assess the risk factors associated with severe events defined as a condition requiring admission to an intensive care unit, the use of mechanical ventilation, or death. RESULTS 28 COVID-19-infected cancer patients were included; 17 (60.7%]. In the first publication, Liang et al. [2] evaluated data on 1590 COVID-19 patients, including 18 (1%) with a cancer diagnosis. The frequency of cancer in this population was 3-times higher than in the general Chinese population (0.29%). The majority of evaluated patients was in follow-up after cancer treatment, and systemic therapy was administered in only six patients. Four patients were diagnosed with lung cancer (2 receiving targeted treatment, 2 – chemotherapy), 1 with renal cell cancer (treated with immunotherapy), 1 with breast cancer (no information on the type of adjuvant treatment). Severe complications associated with COVID-19 were generally more frequent in cancer patients than in the general population (39% vs. 8%), but cancer patients were older (mean age – 63.1 vs. 48.7) and smoked cigarettes (22% vs. 7%). In lung cancer patients, who had undergone chemotherapy or surgery within one month before COVID-19 diagnosis, severe complications were more frequent than in patients in a long-term follow-up 75% vs. 43%, respectively.