Abstract PO-078: Clinical characteristics and outcomes of cancer patients with COVID-19 infection: A retrospective study in a single center in the Philippines
Authors: Pandy Jessa Gilda P. , Alcantara Michelle Joane , Que Frances Victoria , Francia Marie Belle 
Published: December 2020

Background: The COVID-19 pandemic is a rapidly evolving crisis worldwide. Cancer patients represent a highly vulnerable group during this pandemic and are facing the most severe and critical consequences of this outbreak. To date, the data on clinical characteristics and outcomes of COVID-19 infected are largely unknown and limited to case reports and small cohorts. This study aims to contribute to our existing knowledge on the clinical impact of this novel disease on cancer patients. In our local setting, there are currently no known published data on this topic.

Methods: We conducted a retrospective, single-center, cohort study of 19 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and with a pathologic diagnosis of a malignant tumor admitted in a tertiary hospital in Quezon City, Philippines, from March to May 2020. Clinical characteristics, laboratory data, and treatment histories were compared between patients with mild and severe outcomes. Quantitative variables were presented as medians, and qualitative variables were presented by frequencies and percentages. Chi-square test and Fisher’s exact test were applied to analyze the differences between groups.

Results: Between March 15 to May 15, 2020, 19 patients with cancer and COVID-19 infection were included. Median age was 69 (range 37-81), 63.2% were elderly (≥ 60 years), and 57.8% were female. The most common tumor types were breast (26.3%), lung (21%), and genitourinary cancer (10.5%), and the majority had early-stage cancer (63.2%). Fifteen patients (78.9%) had recent anticancer treatment within 2 weeks prior to admission, most commonly cytotoxic (21.05%) and targeted therapy (21.05%). Most common symptoms presented were fever (52.6%), fatigue (36.8%), and cough (31.6%). More than half (57.9%) developed severe outcomes (ARDS, septic shock, acute kidney injury), 10 patients (52.6%) were admitted at the ICU, and 8 patients (42.1%) died. Among patients who developed severe outcomes, most had lung cancer, stage IV disease, recent anticancer treatment, and higher levels of inflammatory markers. Findings of bilateral opacities on chest x-ray (p=0.009) and ground-glass densities on chest CT scan (p = 0.002) were significantly associated with having severe complications. Having nosocomial-acquired infection was also associated with severe outcomes (p=0.004).

Conclusions: Patients with cancer have a high probability of severe illness and mortality when diagnosed with COVID-19. We found that those with recent anticancer treatment, particularly chemotherapy, have higher rates of severe complications and that hospital-acquired infection is common among cancer patients and is associated with severe illness. Our study is limited by its small population, though our findings are consistent with other published studies. Our findings suggest that cancer patients require urgent and special attention during the pandemic, especially those who are receiving anticancer treatment.

Citation Format: Jessa Gilda P. Pandy, Michelle Joane Alcantara, Frances Victoria Que, Marie Belle Francia. Clinical characteristics and outcomes of cancer patients with COVID-19 infection: A retrospective study in a single center in the Philippines [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-078.