High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR

Assaad, Souad; Avrillon, Virginie; Fournier, Marie Line; Mastroïanni, B.; Russias, Bruno; Swalduz, Aurélie; Cassier, Philippe; Eberst, Lauriane; Steineur, Marie Pierre; Kazes, Marianne; Pérol, Maurice; Michallet, Anne Sophie; Rey, Philippe; Erena-Penet, Anne Sophie; Morel, Astrid; Brahmi, Mehdi; Dufresne, Armelle; Trédan, Olivier; Chvetzoff, Gisèle; Fayette, Jérôme; Fouchardière, Christelle de la; Ray‐Coquard, Isabelle; Bachelot, Thomas; Saintigny, Pierre; Tabutin, Mayeul; Dupré, Aurélien; Nicolas‐Virelizier, Emmanuelle; Belhabri, Amine; Roux, P.-E.; Fuhrmann, Christine; Pilleul, F.; Baslé, Arnaud; Bouhamama, Amine; Galvez, Christelle; Herr, A. L.; Gautier, Julien; Chabaud, Sylvie; Zrounba, Philippe; Pérol, David; Blay, Jean Yves

doi:10.1016/j.ejca.2020.05.028

Cited by 108 publications

(155 citation statements)

References 27 publications

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“…After a full-text review, 23 articles were excluded due to the violation of inclusion criteria and the remaining 17 articles were eligible for inclusion in the current analysis. 3,13,15,16,[25][26][27][28][29][30][31][32][33][34][35][36][37]…”

Section: Resultsmentioning

confidence: 99%

“…3,13,15,16,[25][26][27][28][29][30][31][32][33][34][35][36][37] Detailed clinical characteristics of the study patients are reported in Table 1. Seven studies were performed in China, 3,9,13,15,25,26,32 five in the USA, 16,[27][28][29][30] two in Spain, 33,37 one in France, 36 and the other two in Italy. 31,35 Four of the included studies reported data on patients who diagnosis with COVID-19 while they received anti-cancer therapy.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

“…Nine studies were evaluated for anticancer therapy and the risk of death events. 16,26,27,31,32,[34][35][36][37] A random-effects model was used since the heterogeneity test suggested obvious heterogeneity (I 2 = 68.3%, P = .001). The result showed no significant correlation between anti-cancer therapy and the risk of mortality in cancer patients with COVID-19 (OR 1.33, 95% CI 0.84-2.10, P = .229) ( Figure 2).…”

Section: Relationship Between Anti-cancer Therapy and The Risk Of Examentioning

confidence: 99%

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Immunotherapy or other anti-cancer treatments and risk of exacerbation and mortality in cancer patients with COVID-19: a systematic review and meta-analysis

Wang

Huang

2020

OncoImmunology

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Background: This study was designed to investigate whether COVID-19 patients with recently received immunotherapy or other anti-cancer treatments had more severe symptoms and higher mortality. Methods: A literature search was performed using the electronic platforms to obtain relevant research studies published up to June 28, 2020. Odds ratio (OR) and 95% confidence intervals (CI) of research endpoints in each study were calculated and merged. Statistical analyses were performed with Stata 12.0 (Stata Corp LP, College Station, TX). Results: A total of 17 studies comprising 3581 cancer patients with COVID-19 were included in this metaanalysis. SARS-CoV-2-infected cancer patients who recently received anti-cancer treatment did not observe a higher risk of exacerbation and mortality (All p-value >0.05). We also found that surgery, targeted therapy, chemotherapy, immunotherapy, and radiotherapy were not associated with increased risk of exacerbation and mortality (All p-value >0.05). Chemotherapy within 28 d increased the risk of death events (OR 1.45, 95% CI 1.10-1.91, P = .008, p-value = 0.015 for test of interaction), and immunotherapy within 90 d increased the risk of exacerbation (OR 2.53,95%1.30-4.91, P = .006, p-value = 0.170 for test of interaction). Conclusion: Cancer patients recently under anti-cancer treatment before diagnosed with COVID-19, including surgery, targeted therapy, immunotherapy, and radiotherapy, were not associated with increased risk of exacerbation and mortality. Chemotherapy within 28 d increased the risk of mortality, and chemotherapy was not associated with increased risk of severe COVID-19. The role of anti-cancer therapy in cancer patients with COVID-19 still needs further exploration, especially chemotherapy and immunotherapy.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

Section: Relationship Between Anti-cancer Therapy and The Risk Of Examentioning

confidence: 99%

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Immunotherapy or other anti-cancer treatments and risk of exacerbation and mortality in cancer patients with COVID-19: a systematic review and meta-analysis

Wang

Huang

2020

OncoImmunology

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“…Of note, patients with lymphopenia 11 , 41 , 42 , 43 and granulocytosis 33 , 44 were reported to be at an increased risk for severe or fatal COVID-19. Further factors with possible impact on COVID-19 course and outcome are listed in Table 2 .…”

Section: Risk Factorsmentioning

confidence: 99%

Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

Giesen

Sprute²,

Rüthrich

et al. 2020

European Journal of Cancer

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Since its first detection in China in late 2019 the novel coronavirus SARS-CoV-2 and the associated infectious disease COVID-19 continue to have a major impact on global health care and clinical practice. Cancer patients, in particular those with haematological malignancies, seem to be at an increased risk for a severe course of infection. Deliberations to avoid or defer potentially immunosuppressive therapies in these patients need to be balanced against the overarching goal of providing optimal antineoplastic treatment. This poses a unique challenge to treating physicians. This guideline provides evidence-based recommendations regarding prevention, diagnostics and treatment of SARS-CoV-2 infection and COVID-19 as well as strategies towards safe antineoplastic care during the COVID-19 pandemic. It was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) by critically reviewing the currently available data on SARS-CoV-2 and COVID-19 in cancer patients applying evidence-based medicine criteria.

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“…Coronavirus disease 2019 (COVID-19), resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appears to affect children less severely than adults with majority of benign forms and asymptomatic cases [1]. High mortality rate have been recently reported in adult patients with cancer [2,3]. Data is still limited in children with cancer while some reports suggested that they may be quite safe regarding the infection [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Impact on Pediatric Oncology and Hematology: A Report From the French Society of Pediatric Oncology

Gaudichon

Thébault

Félix

et al. 2020

Preprint

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Introduction: Data regarding coronavirus disease 2019 (COVID-19) description are still limited in pediatric oncology. The French society of pediatric oncology (SFCE) has initiated a study to better describe the presentation and evolution of COVID-19 in patients followed in French pediatric oncology and hematology wards. Methods: All patients diagnosed with COVID-19 (polymerase chain reaction [PCR] positive for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], or positive IgM serology, or chest computed tomography scan and clinical signs typical of COVID-19) and followed in a SFCE center were enrolled. Data from medical records were analyzed for all patients enrolled up to the end of May 2020. Results: Data was available for 37 patients. Thirty-one were children under 18 years of age. Nineteen patients were female. Seventeen patients had a solid tumor, 16 had a hematological malignancy and four recently underwent hematopoietic stem cell transplantation (HSCT) for non-oncological conditions. Twenty-eight patients presented symptoms, most often with fever, cough, rhinorrhea and asthenia. Ground-glass opacities were the most frequent radiological finding with abnormalities mostly bilateral and peripherally distributed. Twenty-four patients received chemotherapy a month prior to COVID-19 diagnosis. Most patients did not require hospitalization. Three patients required oxygen at the time of diagnosis. In total, five patients were admitted in an intensive care unit because of COVID-19 and one died from the disease. Conclusion: Children and young adults infected with SARS-CoV-2 and treated for a cancer and/or with a HSCT may be at risk for severe COVID-19 and should be closely monitored. (NCT04433871)

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High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR

Abstract: Background: Cancer patients presenting with COVID-19 have a high risk of death. In this work, predictive factors for survival in cancer patients with suspected SARS-COV-2 infection were investigated.

Cited by 108 publications

References 27 publications

Immunotherapy or other anti-cancer treatments and risk of exacerbation and mortality in cancer patients with COVID-19: a systematic review and meta-analysis

Immunotherapy or other anti-cancer treatments and risk of exacerbation and mortality in cancer patients with COVID-19: a systematic review and meta-analysis

Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

COVID-19 Impact on Pediatric Oncology and Hematology: A Report From the French Society of Pediatric Oncology

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