COVID-19 in cancer patients: clinical characteristics and outcome—an analysis of the LEOSS registry

• Published in: Annals of hematology Vol. 100; no. 2; pp. 383 - 393
• Main Authors: Rüthrich, Maria Madeleine, Giessen-Jung, C., Borgmann, S., Classen, A. Y., Dolff, S., Grüner, B., Hanses, F., Isberner, N., Köhler, P., Lanznaster, J., Merle, U., Nadalin, S., Piepel, C., Schneider, J., Schons, M., Strauss, R., Tometten, L., Vehreschild, J. J., von Lilienfeld-Toal, M., Beutel, G., Wille, K.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2021; Springer Nature B.V
• Subjects: Adolescent; Adult; Age; Aged; Aged, 80 and over; Cancer; Cohort analysis; Comorbidity; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 - virology; Europe - epidemiology; Female; Hematology; Hospital Mortality; Hospitalization - statistics & numerical data; Humans; Kaplan-Meier Estimate; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Neoplasms - epidemiology; Neoplasms - therapy; Oncology; Original; Original Article; Outcome Assessment, Health Care - methods; Outcome Assessment, Health Care - statistics & numerical data; Pandemics; Registries - statistics & numerical data; Retrospective Studies; SARS-CoV-2 - isolation & purification; SARS-CoV-2 - physiology; Severe acute respiratory syndrome coronavirus 2; Young Adult; Europe; COVID-19; SARS-CoV-2; Cancer patients; Cohort study; Adjusted analysis; Pandemic; LEOSS
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-020-04328-4

Introduction Since the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk. Patients and methods We retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality. Results In total, 435 cancer patients were included in our analysis. Commonest age category was 76–85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). After adjustments for other risk factors, mortality was comparable. Conclusion Comparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions.