Clinical characteristics and outcomes of cancer patients with COVID-19 infection: A retrospective study in a single center in the Philippines
Authors: Jessa Gilda P. Pandy, Michelle Joane Alcantara, Frances Victoria Que, Marie Belle Francia
Journal: Clinical Cancer Research (2020)

Background: The COVID-19 pandemic is a rapidly evolving crisis worldwide  Cancer patients represent a highlyvulnerable 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 tocase reports and small cohorts  This study aims to contribute to our existing knowledge on the clinical impact of thisnovel 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 severeacute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and with a pathologic diagnosis of a malignanttumor 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 andpercentages  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 commontumor types were breast (26 3%), lung (21%), and genitourinary cancer (10 5%), and the majority had early-stagecancer (63 2%)  Fifteen patients (78 9%) had recent anticancer treatment within 2 weeks prior to admission, mostcommonly 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, septicshock, acute kidney injury), 10 patients (52 6%) were admitted at the ICU, and 8 patients (42 1%) died  Amongpatients who developed severe outcomes, most had lung cancer, stage IV disease, recent anticancer treatment, andhigher levels of inflammatory markers  Findings of bilateral opacities on chest x-ray (p=0 009) and ground-glassdensities on chest CT scan (p = 0 002) were significantly associated with having severe complications  Havingnosocomial-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 withCOVID-19  We found that those with recent anticancer treatment, particularly chemotherapy, have higher rates ofsevere complications and that hospital-acquired infection is common among cancer patients and is associated withsevere illness  Our study is limited by its small population, though our findings are consistent with other publishedstudies  Our findings suggest that cancer patients require urgent and special attention during the pandemic, especially those who are receiving anticancer treatment