COVID-19 risk for patients undergoing anticancer treatment at the outpatient clinic of the National Cancer Institute of Milan: the COVINT study

Autor: Margherita Ambrosini, Katia Fiorella Dotti, Federico Nichetti, Daniela Polastri, Chiara Pircher, Arianna Ottini, Marta Bini, Laura Ferrari, Filippo de Braud, Rita Leporati, Alessandro Rametta
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
Cancer Research
medicine.medical_treatment
anticancer treatment
chemotherapy
0302 clinical medicine
Neoplasms
Epidemiology
Clinical endpoint
Ambulatory Care
Outpatient clinic
Young adult
Original Research
Aged
80 and over
Incidence (epidemiology)
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Italy
Oncology
030220 oncology & carcinogenesis
Female
Coronavirus Infections
Adult
medicine.medical_specialty
Pneumonia
Viral
Antineoplastic Agents
Cancer Care Facilities
lcsh:RC254-282
cancer care
Time-to-Treatment
03 medical and health sciences
Betacoronavirus
Young Adult
Ambulatory care
Internal medicine
medicine
Humans
Mortality
Pandemics
Aged
Neoplasm Staging
Chemotherapy
business.industry
SARS-CoV-2
pandemic
Cancer
COVID-19
medicine.disease
030104 developmental biology
business
Zdroj: ESMO Open
ESMO Open, Vol 5, Iss Suppl 3 (2020)
ISSN: 2059-7029
DOI: 10.1136/esmoopen-2020-000883
Popis: BackgroundIn the midst of the COVID-19 pandemic, patients with cancer are regarded as a highly vulnerable population. Overall, those requiring hospital admission for treatment administration are potentially exposed to a higher risk of infection and worse outcome given the multiple in-hospital exposures and the treatment immunosuppressive effects.MethodsCOVINT is an observational study assessing COVID-19 incidence among patients receiving anticancer treatment in the outpatient clinic of the Istituto Nazionale dei Tumori di Milano. All consecutive patients with non-haematological malignancies treated with intravenous or subcutaneous/intramuscular anticancer therapy in the outpatient clinic were enrolled. The primary endpoint is the rate of occurrence of COVID-19. Secondary endpoints included the rate of COVID-19-related deaths and treatment interruptions. The association between clinical and biological characteristics and COVID-19 occurrence is also evaluated. COVID-19 diagnosis is defined as (1) certain if confirmed by reverse transcriptase PCR assay of nasopharyngeal swabs (NPS); (2) suspected in case of new symptoms or CT scan evidence of interstitial pneumonia with negative/not performed NPS; (3) negative in case of neither symptoms nor radiological evidence.ResultsIn the first 2 months (16 February–10 April 2020) of observation, 1081 patients were included. Of these, 11 (1%) were confirmed and 73 (6.7%) suspected for COVID-19. No significant differences in terms of cancer and treatment type emerged between the three subgroups. Prophylactic use of myeloid growth factors was adopted in 5.3%, 2.7% and 0% of COVID-19-free, COVID-19-suspected and COVID-19-confirmed patients (p=0.003). Overall, 96 (8.9%) patients delayed treatment as a precaution for the pandemic. Among the 11 confirmed cases, 6 (55%) died of COVID-19 complications, and anticancer treatment was restarted in only one.ConclusionsDuring the pandemic peak, accurate protective measures successfully resulted in low rates of COVID-19 diagnosis, although with high lethality. Prospective patients’ surveillance will continue with NPS and serology testing to provide a more comprehensive epidemiological picture, a biological insight on the impact of cytotoxic treatments on the immune response, and to protect patients and healthcare workers.
Databáze: OpenAIRE
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