Defining the true impact of coronavirus disease 2019 in the at-risk population of patients with cancer

Autor: Sara Reis, Intan Hamid, Sophie McGrath, Susannah Stanway, Alicia Okines, Jaishree Bhosle, Vasileios Angelis, Marco Gerlinger, Heba Soliman, Zayd Tippu, Firza Gronthoud, Robin L. Jones, Emma Cottier, Charlotte Fribbens, Jillian Noble, David Watkins, Spyridon Gennatas, Kroopa Joshi, Pablo Nenclares, Kevin J. Harrington
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
Cancer Research
Multivariate analysis
medicine.medical_treatment
0302 clinical medicine
Antineoplastic Agents
Immunological
Risk Factors
Neoplasms
Epidemiology
Medicine
Young adult
At-Risk Population
Cancer
Aged
80 and over
education.field_of_study
Incidence
Middle Aged
Hospitalization
Exact test
Oncology
030220 oncology & carcinogenesis
Female
Coronavirus Infections
Adult
medicine.medical_specialty
Systemic anticancer therapy
Population
Pneumonia
Viral
Antineoplastic Agents
Poly(ADP-ribose) Polymerase Inhibitors
Article
03 medical and health sciences
Betacoronavirus
Young Adult
Internal medicine
Humans
Chemotherapy
Mortality
education
Pandemics
Protein Kinase Inhibitors
Aged
Radiotherapy
business.industry
SARS-CoV-2
Cyclin-Dependent Kinase 4
COVID-19
Cyclin-Dependent Kinase 6
United Kingdom
Radiation therapy
030104 developmental biology
Logistic Models
Multivariate Analysis
Observational study
business
Zdroj: European Journal of Cancer
ISSN: 1879-0852
0959-8049
Popis: Background In light of the coronavirus disease 2019 (COVID-19) pandemic, cancer centres in the United Kingdom and Europe re-organised their services at an unprecedented pace, and many patients with cancer have had their treatments severely disrupted. Patients with cancer were considered at high risk on sparse evidence, and despite a small number of emerging observational studies, the true incidence and impact of COVID-19 in the ‘at-risk’ population of patients with cancer is yet to be defined. Methods Epidemiological and clinical data were collected prospectively for patients attending the Royal Marsden Hospital and three network hospitals between March 1st and April 30th 2020 that were confirmed to have SARS-CoV2 infection. Significance of clinical and pathological characteristics was assessed using the Fisher's exact test and Wilcoxon rank sum test, whilst univariate and multivariate logistic regression models were used to further assess risk. The number of patients attending in March/April 2020 for face-to-face attendances was also extracted. Findings During the 2-month study period, 867 of 13,489 (6.4%) patients met the criteria leading to swab testing. Of the total at-risk population, only 113 of 13,489 (0.84%) were swab positive, 101 of 13,489 (0.75%) required hospital admission and 29 of 13,489 (0.21%) died of COVID-19. Of the patients that attended the hospital to receive cytotoxic chemotherapy alone or in combination with other therapy, 59 of 2001 (2.9%) were admitted to the hospital for COVID-19–related issues and 20 of 2001 (1%) died. Of the patients that collected targeted treatments, 16 of 1126 (1.4%) were admitted and 1 of 1126 (0.1%) died. Of the 11 patients that had received radiotherapy, 6 of 1042 (0.6%) required inpatient admission and 2 of 1042 (0.2%) died. Interpretations Administration of systemic anticancer therapy appears to be associated with a modest risk of severe COVID-19 infection. Based on this snapshot taken as the first wave of COVID-19 hit our practice, we conclude that continuation of active cancer treatment, even in the palliative setting, is appropriate.
Highlights • Of patients who attended the Royal Marsden Hospital in Mar/Apr 2020, 113/13,489 (0.84%) were coronavirus disease 2019 (COVID-19) swab positive. • One hundred one of 13,489 (0.75%) patients required hospital admission and 29 of 13,489 (0.21%) died of COVID-19. • Systemic anticancer therapy (SACT) and radiotherapy were associated with a relatively modest risk of COVID-19 infection. • Incidence of significant COVID-19 was no higher than that in the general population. • We encourage oncology centres to continue to deliver SACT and radiotherapy.
Databáze: OpenAIRE
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