COVID-19 in breast cancer patients: a subanalysis of the OnCovid registry
Authors: Garrigós Laia , Saura Cristina , Martinez-Vila Clara , Zambelli Alberto , Bower Mark , Pistilli Barbara , Lambertini Matteo , Ottaviani Diego , Diamantis Nikolaos , Lumsden Ailsa , Pernas Sonia , Generali Daniele , Seguí Elia , Viñas Gemma , Felip Eudald , Sanchez Ana , Rizzo Gianpiero , Santoro Armando , Cortellini Alessio , Perone Ylenia , Chester John , Iglesias Maria , Betti Marta , Vincenzi Bruno , Libertini Michela , Mazzoni Francesca , Zoratto Federica , Berardi Rossana , Guida Annalisa , Wuerstlein Rachel , Loizidou Angela , Sharkey Rachel , Aguilar Company Juan , Matas Marta , Saggia Chiara , Chiudinelli Lorenzo , Colomba-Blameble Emeline , Galazi Myria , Mukherjee Uma , Van Hemelrijck Mieke , Marin Mar , Strina Carla , Prat Aleix , Pla Helena , Ciruelos Eva Maria , Bertuzzi Alexia , del Mastro Lucia , Porzio Giampiero , Newsom-Davis Thomas , Ruiz Isabel , Delany Maria Belen , Krengli Marco , Fotia Vittoria , Viansone Alessandro , Chopra Neha , Romeo Margarita , Salazar Ramon , Perez Ignacio , d’Avanzo Francesca , Franchi Michela , Milani Manuela , Pommeret Fanny , Tucci Marco , Pedrazzoli Paolo , Harbeck Nadia , Ferrante Daniela , Pinato David J. , Gennari Alessandra 
Published: November 2021

Background: Cancer patients are at higher risk of COVID-19 complications and mortality than the rest of the population. Breast cancer patients seem to have better prognosis when infected by SARS-CoV-2 than other cancer patients. Methods: We report a subanalysis of the OnCovid study providing more detailed information in the breast cancer population. Results: We included 495 breast cancer patients with a SARS-CoV-2 infection. Mean age was 62.6 years; 31.5% presented more than one comorbidity. The most frequent breast cancer subtype was luminal-like ( n = 245, 49.5%) and 177 (35.8%) had metastatic disease. A total of 332 (67.1%) patients were receiving active treatment, with radical intent in 232 (47.6%) of them. Hospitalization rate was 58.2% and all-cause mortality rate was 20.3%. One hundred twenty-nine (26.1%) patients developed one COVID-19 complication, being acute respiratory failure the most common ( n = 74, 15.0%). In the multivariable analysis, age older than 70 years, presence of COVID-19 complications, and metastatic disease were factors correlated with worse outcomes, while ongoing anticancer therapy at time of COVID-19 diagnosis appeared to be a protective factor. No particular oncological treatment was related to higher risk of complications. In the context of SARS-CoV-2 infection, 73 (18.3%) patients had some kind of modification on their oncologic treatment. At the first oncological reassessment (median time: 46.9 days ± 36.7), 255 (51.6%) patients reported to be fully recovered from the infection. There were 39 patients (7.9%) with long-term SARS-CoV-2-related complications. Conclusion: In the context of COVID-19, our data confirm that breast cancer patients appear to have lower complications and mortality rate than expected in other cancer populations. Most breast cancer patients can be safely treated for their neoplasm during SARS-CoV-2 pandemic. Oncological treatment has no impact on the risk of SARS-CoV-2 complications, and, especially in the curative setting, the treatment should be modified as little as possible.