Descriptive Comparative Analysis of Patients With Cancer Referring to the Emergency Department of an Italian University Hospital Across the Severe Acute Respiratory Syndrome Coronavirus 2 Waves

Abstract

PURPOSE: COVID-19 cancer patients (C19-CP) represent a population at high risk for mortality, whose clinical characteristics are still unknown in the second SARS-CoV-2 wave. The aim of this retrospective study was to compare epidemiology and clinical presentation of C19-CP referring to the emergency department (ED) of our institution (San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy), in a 3-week observation period of the first and second COVID-19 waves, starting from the introduction of the corresponding national lockdowns. METHODS: We retrieved ED admissions from March 9 to 29, 2020, for the first wave, and from October 24 to November 13, 2020, for the second wave. We collected clinical characteristics of consecutive patients with molecularly confirmed SARS-CoV-2 infection. We also considered untested or SARS-CoV-2–negative cancer patients referring to the ED in the reference time frames. RESULTS: C19-CP in the second wave exceeded those in the first wave despite the nonsignificant difference (39 of 576 v 8 of 163; P = .5). Compared with nononcological patients, C19-CP were older (median age 70 years [interquartile range 61-77] v 60 years [interquartile range 45-73]; P = .02) and presented more often with ≥ 2 comorbidities (40.4% v 24.3%; P = .02). Compared with nononcological patients, in C19-CP, respiratory failure (29 of 47 v 321 of 692; P = .049) and hospitalization (37 of 47 v 363 of 692; P = .0004) were higher, with comparable frequencies across the waves. Five of 24 and 10 of 27 hospitalized cancer patients in the first and second waves developed SARS-CoV-2 infection during hospitalization. CONCLUSION: C19-CP were a vulnerable population, irrespective of the COVID-19 waves. This highlights the need to prioritize vaccinations in oncological patients to safeguard and guarantee optimal anticancer care.

Improvements throughout the Three Waves of COVID-19 Pandemic: Results from 4 Million Inhabitants of North-West Italy

“…To the best of our knowledge, despite the worldwide spread of the disease, only a few studies have thoroughly compared the disease severity and the demographic and clinical characteristics of infected patients in subsequent waves [ 11 , 12 , 13 ]: these studies are monocentric [ 11 , 14 , 15 ] or on a regional [ 9 , 10 , 15 , 16 , 17 ] or national level [ 12 , 13 , 18 ] or concern specific populations [ 19 ].…”

“…Moreover, public health institutions worldwide imposed different lockdown restrictions, tracing and control measures aiming, on one side, to reduce the number of cases and to protect the health system from overload or, on the other side, to achieve herd immunity. The systematic interpretation at a global level is challenging because of the enormous heterogeneity in sampling and methodology: many reports are based on mathematical modeling only [ 20 ], others are derived from different healthcare systems or are limited to a single medical center [ 9 , 10 , 14 , 15 , 19 ].…”

Systemic Anti-Cancer Therapy and Metastatic Cancer Are Independent Mortality Risk Factors during Two UK Waves of the COVID-19 Pandemic at University College London Hospital

“…To our knowledge, this is one of the first reports on outcomes in patients with solid cancer encompassing the first and second waves of the COVID-19 pandemic in a UK-based cohort. A number of other studies compared the first and second waves but did not focus on hospitalized patients with cancer and were not UK-based [ 17 , 18 ]. We compared outcomes following SARS-CoV-2 infection in patients with solid cancer compared to a cohort of contemporaneous matched patients without cancer.…”

COVID-19 and Lung Cancer: A Comprehensive Overview from Outbreak to Recovery

“…Specifically, lung cancer patients may have an increased risk of pulmonary complications from COVID-19 (such as admission to the intensive care unit for invasive ventilation) with worse survival outcomes [9,10]. A descriptive analysis of patients entering the hospital emergency department for symptoms related to SARS-CoV-2 infection showed that COVID-positive cancer patients were older, harboring ≥ 2 comorbidities, more frequently developing respiratory failure, at higher rates of hospitalization, compared to the general population [11]. Liang et al, in collaboration with the National Health Commission of the People's Republic of China, identified a prospective cohort of patients hospitalized following the diagnosis of COVID-19 disease.…”