Yusuf KAHYA, Buse Mine KONUK, Cabir YÜKSEL, GÜLE ÇINAR, Kemal OSMAN MEMİKOĞLU

Clinical characteristics of lung cancer patients with COVID-19: Retrospective case series

Clinical characteristics of lung cancer patients with COVID-19: Retrospective case series Introduction: One of the patient groups adversely affected during the COVID19 pandemic is those suffering with cancer. The aim of this study was to evaluate the clinical characteristics and outcomes of lung cancer (LC) patients with COVID-19. Materials and Methods: Three thousand seven-hundred and fifty hospitalized patients with a presumptive diagnosis of COVID-19 in a tertiary referral hospital between March 2020–February 2021 were retrospectively evaluated. Among them, 36 hospitalized COVID-19 patients with a history of primary LC were included in the study. Univariate and multivariate analyses were carried out to assess the risk factors associated with severe disease. Results: Of the 36 patients included in the study, 28 (77%) were males and 8 (23%) were females. Median age was 67 years (min-max: 53-81 years). Six patients (17%) had a diagnosis of small cell LC, whereas 30 patients (83%) had a diagnosis of non-small cell LC. The most common symptoms were fever (n= 28, 77%), coughing and myalgia (n= 21, 58%) and dyspnea (n= 18, 50%). The most common radiological finding was ground glass opacity (GGO) (n= 30), of which 13 was bilateral and 17 was unilateral in distribution. Nearly 30% (n= 11) of LC patients with COVID-19 developed severe disease, 5% (n= 2) of the 36 patients were admitted to intensive care unit and all of these patients eventually expired. LC patients with COVID-19 and patchy consolidation on computed tomography of thorax (Th CT) on admission had a higher risk of developing severe disease in univariate (HR 2.41, 95%CI: 1.4- 4.4, p= 0.04) and multivariate Cox regression analysis (HR 0.48, 95%CI: 0.24-0.97, p= 0.03). Conclusion: Clinical characteristics, laboratory and radiographic findings were similar in LC patients with COVID-19 when compared with the general population, LC patients have a higher mortality rate than the general population, with a 5% mortality rate in our series. Our findings suggest that LC may be a risk factor associated with the prognosis of COVID-19 patients.

PDF

___

1. Peravali M, Joshi I, Ahn J, Kim C. A Systematic Review and Meta-Analysis of Clinical Characteristics and Outcomes in Patients With Lung Cancer with Coronavirus Disease 2019. JTO Clin Res Rep 2021 Mar; 2(3): 100141.

2. Mehta V, Goel S, Kabarriti R, Cole D, Goldfinger M, AcunaVillaorduna A, et al. Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discov 2020 Jul; 10(7): 935-41.

3. Yang K, Sheng Y, Huang C, Jin Y, Xiong N, Jiang K, et al. Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. Lancet Oncol 2020 Jul; 21(7): 904-913.

4. Peng S, Huang L, Zhao B, Zhou S, Braithwaite I, Zhang N, et al. Clinical course of coronavirus disease 2019 in 11 patients after thoracic surgery and challenges in diagnosis. J Thorac Cardiovasc Surg 2020 Aug; 160(2): 585-592.e2.

5. Rogado J, Obispo B, Pangua C, Serrano-Montero G, Martín Marino A, Pérez-Pérez M, et al. Covid-19 transmission, outcome and associated risk factors in cancer patients at the first month of the pandemic in a Spanish hospital in Madrid. Clin Transl Oncol 2020 Dec; 22(12): 2364-8.

6. Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 Transmission in Patients With Cancer at a Tertiary Care Hospital in Wuhan, China. JAMA Oncol 2020 Jul 1; 6(7): 1108-10.

7. Dai M, Liu D, Liu M, Zhou F, Li G, Chen Z, et al. Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak. Cancer Discov 2020 Jun; 10(6): 783-91.

8. Yarza R, Bover M, Paredes D, López-López F, Jara-Casas D, Castelo-Loureiro A, et al. SARS-CoV-2 infection in cancer patients undergoing active treatment: analysis of clinical features and predictive factors for severe respiratory failure and death. Eur J Cancer 2020 Aug; 135: 242-50.

9. Assaad S, Avrillon V, Fournier ML, Mastroianni B, Russias B, Swalduz A, et al. High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARSCOV-2 on RT-PCR. Eur J Cancer 2020 Aug; 135:251-9.

10. World Health Organization (WHO). Report of the WHO– China Joint Mission on Coronavirus Disease 2019 (COVID19). Available from: https://www.who.int/publications/i/ item/report-of-the-who-china-joint-mission-on-coronavirusdisease-2019-(covid- 19). Accessed date: 28 February 2020.

11. World Health Organization (WHO). Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. Available from: https:// https://www.who.int/publications/i/item/10665-332299. Accessed date: 4 April 2020.

12. Rogado J, Pangua C, Serrano-Montero G, Obispo B, Marino AM, Pérez-Pérez M, et al. Covid-19 and lung cancer: A greater fatality rate? Lung Cancer 2020 Aug; 146: 19-22.

13. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar; 21(3): 335-7.

14. Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol 2020 Jul; 31(7): 894-901.

15. T.C. Sağlık Bakanlığı COVID-19 Bilgilendirme Platformu. Available from: https://covid19.saglik.gov.tr/TR-66935/ genel-koronavirus-tablosu.html. Accessed date: 2.March 2021

16. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020 Mar 17; 323(11): 1061-1069.

17. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020 Apr 30; 382(18): 1708-20.