COVID-19 in melanoma patients: Spanish register
Authors: M. Gonzalez-Cao, C. Carrera, J. F. R. Moreno, P. Rodriguez-Jimenez, M. A. Basa, M. F. Rodriguez, T. Puertolas, E. Munoz, J. L. Manzano, I. Marquez-Rodas, J. Martin-Liberal, A. Soria, P. L. Criado, A. G. Castano, A. Boada, P. A. De Miguel, S. Puig, G. Crespo, P. L. Fra, C. A. Zamora, J. Gardeazabal, C. M. Seral, A. Drozdowskyj, M. Provencio, A. Berrocal
Journal: Clinical Cancer Research (2020)

Background: The COVID-19 pandemic has produced devastating effects on the health care system, also affectingcancer patient care  When the pandemic reached Spain by the end of February 2020, the scarce data aboutCOVID-19 infection in cancer patients pointed out a higher risk of complications due to cancer diagnosis and also tocancer therapies  These conjectures led to concerns about hospital follow-up and cancer therapies of cancerpatients  More recent studies have included a higher number of patients, but heterogeneous according to cancertype and tumor stage, with few melanoma patients recorded  Given that different tumor types are associated withspecific comorbidities that have a known impact on COVID-19 evolution, analysis of COVID-19 by cancer types ismandatory  Similarly, analysis by tumor stage is relevant, as advanced cases could have different responses to viralinfection due to tumor-related immunosuppression and general condition deterioration  Methods: In Spain we have completed a national registry of melanoma patients infected by SARS-Cov-2 since April1st, 2020 to June 8th, 2020  Patients with a previous diagnosis of melanoma, presenting with Sars-Cov-2 infectionto our network of hospitals, were eligible for enrollment  A prospective observational study with a case registryfollowed by a retrospective analysis of patient data has been performed  Results: 64 patients have been included  Median age is 68 years (range 6 to 95 years), 22 (34%) patients arefemales, and 35 (55%) patients have stage IV melanoma  Twenty-one (33%) patients were on active anticancertreatment with anti PD-1 antibodies, 19 (30%) patients with BRAF plus MEK inhibitors, and 24 (37%) patients werenot on active treatment  Asymptomatic/paucisymptomatic evolution was recorded in 19 (30%) patients and mildseverity in 13 (20%) patients, not requiring hospital admission by COVID-19  Serious and life-threateningcomplications were recorded in 18 (28%) and 14 (22%) patients, respectively, including 28 (44%) patients whorequired oxygen therapy and 3 (5%) patients who had ICU admission  COVID-19 episode is resolved in 55 cases, including 34 (53%) patients cured, eight (12%) patients who have died due to melanoma progression, and 13 (20%)patients due to COVID-19  The median age of patients who died from COVID-19 was 74 years (range 49 to 91), while for those cured it was 64 years (range 6 to 95);85% of patients who died were males, while this ratedecreased to 62% for those cured  The mortality rate from COVID-19 was 20% for both stage IV and localizedmelanoma, while according to melanoma treatment it was 21%, 16%, and 21% for immunotherapy, BRAF plus MEKinhibitors, and for those who were not undergoing active cancer treatment, respectively  Conclusion: Our results show that the risk of death in melanoma patients is higher in males and older patients, andit is similar according to tumor stage and melanoma therapy  The impact of cancer diagnosis and treatments onCOVID-19 evolution is lower than previously expected