Abstract S06-02: Disruption to care of patients with thoracic malignancies: A COVID-19 and cancer outcomes study
Authors: Bhalla Sheena , Bakouny Ziad , Schmidt Andrew L. , Steinharter John A. , Tremblay Douglas A. , Awad Mark M. , Kessler Alaina J. , Haddad Robert I. , Evans Michelle , Busser Fiona , Wotman Michael , Curran Catherine R. , Zimmerman Brittney S. , Bouchard Gabrielle , Jun Tomi , Nuzzo Pier V. , Qin Qian , Hirsch Laure , Feld Jonathan , Kelleher Kaitlin M , Seidman Danielle , Huang Hsin-Hui , Labaki Chris , Anderson-Keightly Heather M. , Alaiwi Sarah Abou , Rosenbloom Talia D. , Stewart Penina S. , Galsky Matthew D. , Choueiri Toni K. , Doroshow Deborah B. 
Published: March 2021

Abstract
Introduction: Patients with thoracic malignancies are susceptible to severe outcomes from coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the disruption to care of patients with thoracic malignancies during the COVID-19 pandemic. Methods: The COVID-19 and Cancer Outcomes Study (CCOS) is a multicenter prospective cohort study comprised of adult patients with a current or past history of hematological malignancy or invasive solid tumor who had an outpatient medical oncology visit on the index week between March 2 and March 6, 2020 at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai in New York, NY (MSSM) or the Dana-Farber Cancer Institute in Boston, MA (DFCI). An electronic data capture platform was used to collect patient-, cancer-, and treatment-related variables during the three months prior to the index week (the baseline period) and the following three months (the pandemic period). Two-by-three contingency tables with Fisher’s exact tests were computed. All tests were two-tailed and considered statistically significant for p&lt;0.05. All analyses were done in the R statistical environment (v3.6.1). Results: The overall cohort included 2365 patients, of which 313 had thoracic malignancies, 1578 had other solid tumors, and 474 had hematological malignancies. At a median follow-up of 84 days (95% confidence interval, 82-84), 13 patients with thoracic malignancies (4.1%) had developed COVID-19 (vs. other solid: 63 [4.0%] and hematological: 52 [11.0%]; p&lt;0.001). When comparing data from the pandemic period to the baseline period, patients with thoracic malignancies had a decrease in the number of in-person outpatient visits (thoracic: 209 [66.8%] vs. other solid: 749 [47.5%] vs. hematological: 260 [54.9%]; p&lt;0.001) and an increase in the number of telehealth visits (thoracic: 126 [40.3%] vs. other solid: 465 [29.5%] vs. hematological: 168 [35.4%]; p&lt;0.001). During the pandemic period, 33 (10.5%) patients with thoracic malignancies experienced treatment delays due to the pandemic (vs. other solid: 127 [8.0%] and hematological: 79 [16.7%]; p&lt;0.001), and 26 (8.3%) patients with thoracic malignancies experienced delays in cancer imaging or diagnostic procedures (vs. other solid: 63 [4.0%] and hematological: 26 [5.5%]; p=0.003). Discussion: In this prospective cohort study, patients with thoracic malignancies were not at increased risk of developing COVID-19 compared to patients with other cancers, but experienced significant cancer care disruption during the COVID-19 pandemic with a higher likelihood of decreased in-person visits and increased telehealth visits compared to patients with other malignancies. Focused efforts to ensure continuity of care for this vulnerable patient population are warranted.
Citation Format: Sheena Bhalla, Ziad Bakouny, Andrew L. Schmidt, John A. Steinharter, Douglas A. Tremblay, Mark M. Awad, Alaina J. Kessler, Robert I. Haddad, Michelle Evans, Fiona Busser, Michael Wotman, Catherine R. Curran, Brittney S. Zimmerman, Gabrielle Bouchard, Tomi Jun, Pier V. Nuzzo, Qian Qin, Laure Hirsch, Jonathan Feld, Kaitlin M Kelleher, Danielle Seidman, Hsin-Hui Huang, Chris Labaki, Heather M. Anderson-Keightly, Sarah Abou Alaiwi, Talia D. Rosenbloom, Penina S. Stewart, Matthew D. Galsky, Toni K. Choueiri, Deborah B. Doroshow. Disruption to care of patients with thoracic malignancies: A COVID-19 and cancer outcomes study [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S06-02.